Unsuspected or Unacknowledged Depressive Symptoms in Young Adult Emergency Department Patients

Abstract

Objectives: The objective was to determine the frequency of unsuspected or unacknowledged depressive symptoms among young adult emergency department (ED) patients. Methods:The Beck Depression Inventory-II (BDI-II) and a demographic ⁄ lifestyle questionnaire were administered to a cross-section of medically stable, English-speaking young adult ED patients (aged 18-23 years) with nonpsychiatric chief complaints. The frequency of moderate to severe depressive symptoms was determined. Group results were analyzed with descriptive statistics; multivariate analysis assessed for patient characteristics associated with depressive symptoms.Results: A total of 2,898 patients were screened; 2,255 were eligible for enrollment, and 1,264 enrolled (56%; 64% female, 42% African American; mean age = 21 [±1.7] years). Twenty-nine percent had BDI-II scores consistent with moderate to severe depressive symptoms. Patient characteristics associated with depressive symptoms included knowledge of someone who had intentionally hurt him-or herself (odds ratio [OR] = 2) or died a violent nonaccidental death (OR = 1.4), low personal income (OR = 1.8), chronic health issues (OR = 1.7), cigarette smoking (OR = 1.6), and African American race (OR = 1.5). Those who attended school (OR = 0.5), engaged in frequent social activities (OR = 0.5), or drove a car (OR = 0.7) were less likely to have depressive symptoms. Patients lacked insight into their depressive symptoms.Conclusions: There is a high prevalence of depressive symptoms in young adult ED patients. Young adults often do not recognize, or are reluctant to acknowledge, depressive symptoms. Specific patient characteristics may be useful in deciding which young adults should undergo ED screening for depression.ACADEMIC EMERGENCY MEDICINE 2009; 16:288-294 ª

ED Patients with Prolonged Complaints and Repeat ED Visits Have an Increased Risk of Depression

“…Of the 425 patients, 245 (58%) were classified with no or minimal depression; 62 patients (15%) mild depression; 85 patients (20%) moderate depression; and 33 (8%) severe depression (Figure). These findings are similar to previous studies calculating the prevalence of depression in the ED 2. For the remainder of this study, patients were grouped into two cohorts: patients with no or minimal depression (BDI-II score; 0–13) and patients with mild, moderate or severe depression (BDI-II score; 14–63) (Table 1).…”

Vitamin D, Depression and Coping Self-Efficacy in Young Women: Longitudinal Study

“…Only 10% of the participants had selfreported depression scores indicative of moderate (n = 3) or severe depression (n = 2) at time 3 (time 1 and time 2 yielded similar results). This is significantly lower than the 29% of young adults reported to have moderate to severe depression in a study by Brios, Mann, Hanson, and Cen (2009) and the 14.2% reported for Caucasian women by Kwasky and Groh (2012).…”

Vitamin D and Depression

“…The percentage of women who scored in the depressed range on the BDI-II is both supportive and contrary to other published reports of young adults. For example, Brios, Mann, Hanson, and Cen (2009) found that 29% of adults (18-23 years) using the emergency department (ED) for physical ailments were depressed according to the BDI-II. A study by Ialongo et al (2004) reported depression in 11.4% of their sample of urban African American women aged 19 to 22 years ( N = 100).…”

“…Young adults often do not recognize or are reluctant to admit that they are experiencing symptoms of depression (Rickwood, Deane, & Wilson, 2007). In a recent study, 29% of young adults seeking medical treatment in the emergency department for a physical complaint were also experiencing moderate to severe depressive symptoms (Brios, Mann, Hanson, & Cen, 2009). Minority status is a confounding variable associated with higher rates of depressive symptoms, particularly in African American women (Brios et al, 2009).…”

“…In a recent study, 29% of young adults seeking medical treatment in the emergency department for a physical complaint were also experiencing moderate to severe depressive symptoms (Brios, Mann, Hanson, & Cen, 2009). Minority status is a confounding variable associated with higher rates of depressive symptoms, particularly in African American women (Brios et al, 2009). Young African American and Caucasian women (18-25 years old) are the most at risk for experiencing depression, yet do not access mental health treatment (Kahn et al, 2009).…”