期刊名称：Research in Psychotherapy: Psychopathology, Process and Outcome
印刷版ISSN：2239-8031
出版年度：2020
卷号：23
期号：2
页码：189-196
DOI：10.4081/ripppo.2020.459
出版社：PAGEPress Publications
摘要：The objective of this study is to assess the potential role of Emergency Department (ED) for early detection of mental disorders.
Two cohorts (6,759 subjects aged 14 to 24 accessing ED, 165 subjects with mental disorders) were matched by ID and merged. Primary
outcome was the proportion of individuals accessing ED before receiving a diagnosis of mental disorder in Mental Health Service
(MHS). Secondary outcomes were age of first access to ED in subjects later accessing to MHS, and time from first ED access to receiving
a diagnosis of mental disorder at MHS. We assessed whether gender, severity of ED presentation, and number of ED accesses predicted
primary outcome. Almost half of individuals who later developed mental disorders (49.7%) accessed ED before access to MHS. Mean
age of first ED contact among those later accessing to MHS was 17.34 (2.1), and ED access preceded access to MHS by 3.68 (2.11)
years. Gender and severity of ED presentation were not associated with the access to MHS, while higher number of ED accesses was
associated with later access to MHS (OR range: 1.17-1.36, p<0.05). Despite its limitations, the present study suggests ED might represent
a contact point for individuals who later access to MHS. Future early detection programs should involve ED in their outreach and
screening approaches. Additional studies are needed to assess if subjects earlier accessing to ED are at risk-of-developing or already
suffer from a mental disorder, and to validate screening instruments specifically designed for ED.
关键词：Mental disorders; early detection; prevention; emergency department; prediction; adolescent psychiatry; pathway to care
