Alcohol misuse and report of recent depressive symptoms among ED patients

Could reasons for admission help to screen unhealthy alcohol use in emergency departments? A multicenter French study

Background

Many patients admitted to general emergency departments (EDs) have a pattern of drinking that could lead to future alcohol-related complications. However, it is often difficult to screen these patients in the context of emergency. The aim of this study is to analyze whether reasons for admission could help to screen patients who have an unhealthy alcohol use.

Method

Patients were recruited among six public hospital ED in France, between 2012 and 2014. During a one-month period in each hospital, anonymous questionnaires including sociodemographic questions, AUDIT-C and RAPS4-QF were administered to each patients visiting the ED. The reason for admission of each patient was noted at the end of their questionnaire by the ED practitioner.

Results

Ten thousand Four hundred twenty-one patients were included in the analysis. Patients who came to the ED for injuries and mental disorders were more likely to report unhealthy alcohol use than non-harmful use or no use. Among male patients under 65 years old admitted to the ED for a mental disorder, 24.2% drank more than four drinks (40 g ethanol) in typical day at least four time a week in the last 12 months. Among these patients, 79.7% reported daily or almost daily heavy episodic drinking (HED, 60 g ethanol), and all were positive on the RAPS4-QF.

Conclusion

This study highlights that unhealthy alcohol use is frequent among ED patients and particularly among those who come for injuries or mental disorders. Men under 65 years old with a mental disorder require special attention because of their increased prevalence of daily or almost daily HED.

Prevalence of undiagnosed depression among patients with hypertension: A cross-sectional study of Malaysian primary care perspective

Introduction

This study aimed to determine the prevalence of suspected depression and its associated factors among patients with hypertension in a Malaysian primary care clinic.

Method

This cross-sectional study was conducted in a primary care clinic from 1 June to 31 August 2019 using the Patient Health Questionnaire-9.

Results

The prevalence of suspected depression was 9.0%. The significant predictors of depression were Indian ethnicity (adjusted odd ratio [AOR]: 2.373; confidence interval [CI]: 1.147-4.907), divorce (AOR: 3.5; CI: 1.243-9.860), singleness (AOR: 2.241; CI: 1.182-4.251), heavy episodic drinking (AOR: 7.343; CI: 2.494-21.624), low physical activity level (AOR: 1.921; CI: 1.0932.274), low fibre intake (AOR: 1.836; CI: 1.061-3.178), uncontrolled blood pressure (AOR: 1.800; CI: 1.134-2.858) and presence of hypertension complications (AOR: 3.263; CI: 2.053-5.185).

Conclusion

Primary health care providers must screen for depression among patients with hypertension, particularly those within high-risk groups, and implement interventions that address modifiable risk factors.

Associated factors to depression diagnosed during incarceration in Peruvian male prisoners: a sub-analysis of the national census of prison population

PURPOSE

Depression has become a major health concern, particularly in developing countries. This disorder is highly prevalent among certain vulnerable populations, such as prisoners. In Peru, prisons are overcrowded, and the health of prisoners is neglected. Thus, this study aims to estimate the prevalence of depression diagnosed during incarceration in male inmates from all Peruvian prisons and assess its associated factors.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional study was conducted based on the secondary data analysis of the National Census of Prison Population 2016 in Peru. This study included records of prisoners who reported whether they were diagnosed with depression by a health-care professional after admission into the prisons. Descriptive, bivariate and multivariable analyses were performed.

FINDINGS

Of the 63,312 prisoners included in this study, 1,007 reported an in-prison diagnosis of depression by a health-care professional, which represents a prevalence of 1.59%. Substance use disorder (adjusted prevalence ratio [aPR] 3.10; 95% confidence interval [CI]: 1.91-5.03), hypertension (aPR 7.20; 95% CI: 6.28-8.24) and previous discrimination (aPR 1.97; 95% CI: 1.62-2.40) were strongly associated with depression, even when adjusting for multiple confounders. Other directly associated variables were, for example, violence during childhood, infrequent visits in prison and diabetes.

ORIGINALITY/VALUE

The right of prisoners to adequate health care is being neglected in Peru. Mental health is a cornerstone of health quality. Acknowledging which factors are associated with depression in prison is important to implement strategies to improve the mental health of prisoners.

Social Isolation, Loneliness and Generalized Anxiety: Implications and Associations during the COVID-19 Quarantine

The COVID-19 pandemic has resulted in a predominantly global quarantine response that has been associated with social isolation, loneliness, and anxiety. The foregoing experiences have been amply documented to have profound impacts on health, morbidity, and mortality. This narrative review uses the extant neurobiological and theoretical literature to explore the association between social isolation, loneliness, and anxiety in the context of quarantine during the COVID-19 pandemic. Emerging evidence suggests that distinct health issues (e.g., a sedentary lifestyle, a diminished overall sense of well-being) are associated with social isolation and loneliness. The health implications of social isolation and loneliness during quarantine have a heterogenous and comorbid nature and, as a result, form a link to anxiety. The limbic system plays a role in fear and anxiety response; the bed nucleus of the stria terminalis, amygdala, HPA axis, hippocampus, prefrontal cortex, insula, and locus coeruleus have an impact in a prolonged anxious state. In the conclusion, possible solutions are considered and remarks are made on future areas of exploration.

Effects of low-dose alcohol exposure in adolescence on subsequent alcohol drinking in adulthood in a rat model of depression

OBJECTIVE

Adolescence drinking and subsequent development of alcohol use disorder (AUD) is a worldwide health concern. In particular, mood dysregulation or early alcohol exposure can be the cause of heavy drinking in some individuals or a consequence of heavy drinking in others.

METHODS

This study investigated the effects of voluntary alcohol intake during adolescence, i.e. continuous 10% alcohol access between postnatal days (PND) 29 to 43 and olfactory bulbectomy (OBX) model of depression (performed on PND 59) on alcohol drinking in Wistar rats during adulthood (PND 80-120, intermittent 20% alcohol access). In addition, the effect of NBQX, an AMPA/kainate receptor antagonist (5 mg/kg, IP) on spontaneous alcohol consumption was examined.

RESULTS

Rats exposed to 10% alcohol during adolescence exhibited a lower 20% alcohol intake in the intermittent paradigm during adulthood, while the OBX-induced phenotype did not exert a significant effect on the drinking behaviour. NBQX exerted a transient reduction on alcohol intake in the OBX rats.

CONCLUSIONS

Our results indicate that exposure to alcohol during adolescence can affect alcohol drinking in adulthood and that further exploration of AMPA and/or kainate receptor antagonists in co-morbid alcoholism-depression is warranted.

Associations between clusters of perceived social support level, depression, and suicidal ideation among transgender women: a latent class analysis

Background: Suicide is recognized as a pivotal public health issue and has become a significant cause of death worldwide. Transgender persons are at greater risk of suicide than the general population. This study aims to identify suicidal ideation in transgender women according to clusters of depressive symptoms, and levels of perceived social support using latent class analysis (LCA) and identify associations between the identified classes and suicidal ideation.

Design and methods: This cross-sectional study was conducted between March 2019 and May 2019 using the snowball sampling method in a sample of 280 transgender women in Bangkok, Thailand. Data were collected using a self-administered questionnaire, and LCA was performed according to the level of perceived social support and depression. The questionnaire included the following: demographic information, measures of social support (MSPSS), depression (CES-D), and suicidal ideation (C-SSRS). Multivariable logistic regression was used to examine the associations between the identified classes and suicidal ideation.

Results: The multivariable logistic regression analysis showed that suicidal ideation was significantly associated with perceived moderate social support with depression [class 1; odds ratio (OR) 5.57, 95% confidence interval (CI) 2.64-11.71; P<0.001] and perceived low social support with depression (class 4; OR 4.55, 95% CI 1.67-12.42; P=0.003) after adjusting for income sufficiency, chronic disease, and alcohol drinking.

Conclusions: The findings indicate that less perceived social support and depression significantly increased suicidal ideation among transgender women. To tackle this issue efficiently, it is necessary for public health service providers, parties, and individuals concerned to collaborate and prioritize key agendas that support the social and psychological aspects of transgender women.

Perceived social support and its relationship with depression among Bangkok's trans women

Purpose

The purpose of this paper is to evaluate the prevalence of depression and to determine the association between social support and depression among transgender women in Bangkok, Thailand.

Design/methodology/approach

A cross-sectional study was conducted among 280 transgender women in Bangkok, Thailand between March 2019 and May 2019 using the snowball sampling method. Data were collected through a self-administered questionnaire. The questionnaire included demographic questions and measures of social support (MSPSS) and depression (CES-D). Multivariable logistic regression analysis was employed to explore the association between social support and depression.

Findings

The prevalence of depression among transgender women was 58.2%. Multivariable logistic regression analysis indicated that depression was significantly associated with perceived low social support (OR: 9.55, 95%CI: 2.10–43.39) and moderate social support (OR: 2.03, 95%CI: 1.19–3.46) after being adjusted for religion, sufficient income and alcohol drinking.

Originality/value

Transgender women were prone to experience a higher prevalence of depression than the general population. Social support would reduce the risk of depression among transgender women. Therefore, social support service systems for transgender women should be embedded into organizations concerned.

Factors Related to the Level of Depression and Suicidal Behavior Among Men With Diagnosed Depression, Physically Ill Men, and Healthy Men

Depression is the most common psychiatric disorder in people who die by suicide. Awareness of risk factors for suicide in depression is important for clinicians. The study was aimed at establishing models of factors related to the level of depression and suicidal behavior among men from three different groups-in men with depressive disorder, in comparison to men with physical disorder and healthy men. A total of 598 men were included in the study. The following questionnaires were used in research model: test with sociodemographic variables, AUDIT Test, Fagerström Test, Generalized Self-Efficacy Scale (GSES), Inventory for Measuring Coping with Stress (Mini-COPE), Resilience Evaluation Questionnaire (KOP-26), Suicide Behaviors Questionnaire-Revised (SBQ-R) by Osman, and Gotland Male Depression Scale. In men with depression, the positive factors strongly related to the intensity of depression and suicidal behavior were as follows: vocational education, active coping, turning toward religion, social competence for resilience, and bachelor status. The factors negatively related to the intensity of depression and suicidal behavior in this group were as follows: unemployed status, student status, low satisfaction with the financial situation, having children, history of mental disorders in family, alcohol addiction, and seeking instrumental support. In the group of men with physical disorders, the following protection factors were identified: the medium or small city as a place of living, active coping, venting, and personal competence. The following risk factors were identified in this group: psychiatric treatment in the past. In the group of healthy men, the following protective factors were identified: the medium city as a place of living, positive reappraisal, planning abilities, and personal and social competence for resilience. In this group, the following risk factors were identified: vocational and higher education, student status, satisfaction with the financial situation, having more than one children, the occurrence of mental disorders in the family, the occurrence of alcohol abuse in the family, and use of psychoactive substances as a strategy of dealing with stress. The risk factors identified in this study should be included in the clinical assessment of depression and suicidal behavior risk in male patients. There are some protective factors identified, including productive coping and personal and social competencies, which can be developed and should be especially considered and strengthened in mental health promotion programs aimed at men.

Prevalence, Demographic, and Clinical Correlates of Comorbid Depressive Symptoms in Chinese Psychiatric Patients With Alcohol Dependence

BACKGROUND

Depressive symptoms are common among psychiatric patients with alcohol dependence (AD). However, the prevalence and clinical correlates of comorbid depressive symptoms are less well studied in Chinese Han patients.

METHODS

In this hospital-based survey, we recruited 378 psychiatric patients diagnosed with AD according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV). All patients completed the Beck Depression Inventory (BDI) to evaluate depressive symptoms and the Alcohol Use Disorders Identification Test (AUDIT) to assess the severity of drinking.

RESULTS

Compared to patients without depressive symptoms, 48.9% (185/378) of the patients with comorbid depressive symptoms were younger, had a more unstable marital status, had a higher AUDIT total score, and had a higher adverse consequences subscore (all P < 0.05). Further logistic regression analysis showed that unstable marital status (Odds ratios [OR] = 2.20, 95% confidence interval [CI] 1.21-3.99) and AUDIT total score (OR=1.07, 95% CI 1.03-1.11) were significantly associated with depressive symptoms.

CONCLUSIONS

Our findings indicate high comorbidity between AD and depressive symptoms in Chinese psychiatric patients. Moreover, some variables are correlates of comorbid depressive symptoms. Particular attention should be paid to the early detection and intervention for this comorbid condition and its risk factors.

Binge drinking and subsequent depressive symptoms in young women in Australia

BACKGROUND

The long-term impact of binge drinking on subsequent depressive symptoms is unclear. The aims were to identify longitudinal patterns of binge drinking and whether binge drinking preceded depressive symptoms in the short-term (1-6 years) and long-term (10-15 years).

METHODS

Longitudinal data from 1996, 2000 and 2009 mailed surveys of 8,197 women in the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. Latent class analysis was used to identify binge drinking patterns and logistic regression to estimate associations with subsequent depressive symptoms.

RESULTS

Five binge drinking trajectories were identified with predicted proportions of women who were very infrequent (24%), fluctuating infrequent (17%), frequent (17%), very frequent (26%) or extremely frequent binge drinkers (16%) between 16 and 21 years. At 22-27 years, depressive symptoms were significantly higher for extremely frequent binge drinkers (31% versus 21% in the short-term; 22% versus 16%-18% in the long-term) than for less frequent bingers. Unadjusted odds of depressive symptoms were 1.70 (95%CI:1.38;2.08) times for extremely frequent binge drinkers than very infrequent bingers and were 1.30 (95%CI:1.04;1.63) after adjusting for demographics, relationships and experience of violence. At 31-36 years, the odds of depressive symptoms were 1.34 (95%CI:1.09-1.64) times for extremely frequent than very infrequent binge drinkers, but were not significant after adjusting for relationships and violence.

CONCLUSIONS

Extremely frequent binge drinking (more than weekly) in late adolescence appears to elevate the risk of subsequent depressive symptoms in young women in their early twenties and thirties, emphasising the need for preventive strategies to curb binge drinking.

Multivariate analysis of binge drinking in young adult population: Data analysis of the 2007 Survey of Lifestyle, Attitude and Nutrition in Ireland

AIMS

Alcohol use is the third highest risk factor for disease and disability. This study explored the association between binge drinking and mental health, general health, and diet and nutrition of young adults.

METHODS

A sub-sample of 2590 adults aged 18-29 years was selected from 10 364 participants in the survey to investigate the effect of binge drinking exposure on depression, anxiety, quality of life and nutrition. The Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) was used to assess hazardous drinking. A short version of the World Health Organization Composite International Diagnostic Interview was used to assess mental health. The quality of life was measured through the World Health Organization Quality of Life Survey. Multivariate regression analysis was performed. Potential confounders were age, gender, social class and AUDIT-C score. A two-tailed P-value was presented with a significance cut-off point at 0.05.

RESULTS

Univariate regression analysis showed significant associations between binge drinking and depression (odds ratio [OR] = 1.8; P < 0.03), eating fried food (OR = 0.4; P < 0.001) and poor quality of life (OR = 1.5; P = 0.01). In a multivariate model adjusted for age, gender, social class and the AUDIT-C results, the association between binge drinking and depression disappeared despite the high risk indicated by the OR in the univariate analysis. A significant relation was found between binge drinking and eating fried food (OR = 0.43 and P < 0.001) and quality of life (OR = 1.09; P = 0.01) in the fully adjusted models.

CONCLUSIONS

The link between alcohol drinking and mental health remains poorly understood. More research into the relation between different aspects of alcohol consumption, mental health and quality of life is required.

The long arm of parental addictions: the association with adult children's depression in a population-based study

Parental addictions have been associated with adult children's depression in several clinical and population-based studies. However, these studies have not examined if gender differences exist nor have they controlled for a range of potential explanatory factors. Using a regionally representative sample of 6268 adults from the 2005 Canadian Community Health Survey (response rate=83%), we investigated the association between parental addictions and adulthood depression controlling for four clusters of variables: adverse childhood experiences, adult health behaviors, adult socioeconomic status and other stressors. After controlling for all factors, adults exposed to parental addiction had 69% higher odds of depression compared to their peers with non-addicted parents (OR=1.69; 95% CI, 1.25-2.28). The relationship between parental addictions and depression did not vary by gender. These findings underscore the intergenerational consequences of drug and alcohol addiction and reinforce the need to develop interventions that support healthy childhood development.

Correlates of depressive symptoms among alcohol-using methadone maintained adults

BACKGROUND

Alcohol-using clients are considered at great risk for hepatitis and ongoing liver damage. This study explores the correlates of depression among a sample of methadone maintained treatment (MMT) adults in the Los Angeles area, and is part of a larger study on hepatitis health promotion among MMT clients who use alcohol.

OBJECTIVES

We sought to determine correlates of depressive symptoms among moderate and heavy alcohol-using adults enrolled in methadone maintenance.

METHODS

A cross-sectional correlation study was conducted of baseline data from a randomized control trial of adults (N= 189) receiving MMT in Los Angeles. Depressive symptoms were measured with the 10-item short-form CES-D.

RESULTS

Multiple regression analysis revealed that pain and social support were key correlates of depressive symptoms. More pain was associated with higher levels of depressive symptoms (p= .001), while more social support was related to lower depressive symptom severity (p= .001). Having been in sufficiently poor health that a blood transfusion, clotting factors, or an organ transplant was necessary was associated with greater depressive symptomatology, as was having injected drugs in the past month (p= .024).

CONCLUSIONS

The findings from this investigation can aid clinicians in selecting clients to monitor for early signs of depression and encourage early treatment for opioid users with comorbidities.

SCIENTIFIC SIGNIFICANCE

The use of an interdisciplinary team to care for MMT clients, routinely screen for depressive symptoms, and emphasize adequate pain control is indicated.

Correlates of depressed mood among young stimulant-using homeless gay and bisexual men

Homeless gay and bisexual (G/B) men are at risk for suicide attempts and have high risk of depressed mood, defined as elevated level of depressive symptoms. This study describes baseline socio-demographic, cognitive, psychosocial, and health- and drug-related correlates of depressed mood in 267 stimulant-using homeless G/B young men who entered a study designed to reduce drug use. G/B men without social support were 11 times more likely to experience depressed mood than their counterparts who had support; those who reported severe body pain were almost six times more likely to report depressed mood than those without pain. Other factors that increased risk of depressed mood included being homeless in the last four months, injecting drugs, reporting poor or fair health status, and high levels of internalized homophobia. This study is one of the first studies to draw a link between pain experienced and depressed mood in homeless young G/B men. Understanding the correlates of depressed mood among homeless G/B young men can help service providers design more targeted treatment plans and provide more appropriate referrals to ancillary care services.

Alcohol misuse and multiple sexual partners

INTRODUCTION

We examine the association between self-reported alcohol misuse and alcohol use within 2 hours of having sex and the number of sexual partners among a sample of African-American and Latino emergency department (ED) patients.

METHODS

Cross-sectional data were collected prospectively from a randomized sample of all ED patients during a 5-week period. In face-to-face interviews, subjects were asked to report their alcohol use and number of sexual partners in the past 12 months. Data were analyzed using multiple variable negative binomial regression models, and effect modification was assessed through inclusion of interaction terms.

RESULTS

The 395 study participants reported an average of 1.4 (standard error = 0.11) sexual partners in the past 12 months, 23% reported misusing alcohol, and 28% reported consuming alcohol before sex. There was no statistically significant association between alcohol misuse and the number of sexual partners; however, alcohol before sex was associated with a larger number of sexual partners in the past year. Moreover, among those who misused alcohol, participants who reported alcohol before sex were 3 times more likely to report a higher number of sexual partners (risk ratio = 3.2; confidence interval [CI] =1.9-5.6). The association between alcohol use before sex and number of sexual partners is dependent upon whether a person has attributes of harmful drinking over the past 12 months. Overall, alcohol use before sex increases the number of sexual partners, but the magnitude of this effect is significantly increased among alcohol misusers.

CONCLUSION

Alcohol misusers and those who reported having more than 1 sexual partner were more likely to cluster in the same group, ie, those who used alcohol before sex. Efforts to reduce the burden of sexually transmitted diseases, including human immunodeficiency virus, and other consequences of risky sexual behavior in the ED population should be cognizant of the interplay of alcohol and risky sexual behaviors. EDs should strive to institute a system for regular screening, brief intervention, and referral of at-risk patients to reduce negative consequences of alcohol misuse, including those of risky sexual behaviors.

Behavioural and neuroinflammatory effects of the combination of binge ethanol and MDMA in mice

RATIONALE

Binge drinking is a common pattern of alcohol consumption among young people. Binge drinkers are especially susceptible to brain damage when other substances are co-administered, in particular, 3,4-methylendioxymethamphetamine (MDMA).

OBJECTIVE

To evaluate the behavioural consequences of voluntary binge ethanol consumption, alone and in combination to MDMA. Also, to elucidate the effects of the combined consumption of these two drugs on neuroinflammation.

MATERIALS AND METHODS

Adolescent mice received MDMA (MDMA-treated mice), ethanol (ethanol-treated mice group) or both (ethanol plus MDMA-treated mice). Drinking in the dark (DID) procedure was used as a model of binge. Body temperature, locomotor activity, motor coordination, anxiety-like and despair behaviour in adolescent mice were evaluated 48 h, 72 h, and 7 days after the treatments. Also, neuroinflammatory response to these treatments was measured in the striatum.

RESULTS

The hyperthermia observed in MDMA-treated mice was abolished by pre-exposition to ethanol. Ethanol plus MDMA-treated mice showed lower locomotor activity. Ethanol-treated mice showed motor coordination impairment and increased despair behaviour. Anxiety-like behaviour was only seen in animals that were treated with both drugs. Contrarily, neuroinflammation was mostly seen in animals treated only with MDMA.

CONCLUSIONS

Ethanol and MDMA co-administration increases the neurobehavioural changes induced by the consumption of each one of these drugs. However, as ethanol consumption did not increase neuroinflammatory responses induced by MDMA, other mechanisms, mediated by ethanol, are likely to account for this effect and need to be evaluated.

The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence

The presence of depression in alcohol-dependent persons is likely to influence treatment process and outcomes. Identification of depression is important though not every depressed alcohol-dependent person requires treatment with antidepressants. Understanding the association between depression and alcohol dependence is essential for proper management of alcohol dependence. Objectives. To determine the prevalence of depression among alcohol-dependent persons before and after alcohol detoxification and rehabilitation. Design. Clinical trial with pre-/postmeasurements. Method. The CIDI and WHO-ASSIST were administered to 188 alcohol-dependent persons at intake and after six months. A researcher-designed sociodemographic questionnaire was also administered at intake. Results. The prevalence of depression among alcohol-dependent persons is high (63.8%) with a significant association between depression and the mean AUDIT score. At posttest, depressed participants had a statistically significant craving for alcohol. Conclusion. Alcohol dependence is associated with major depression.

Alcohol and depression

AIMS

To examine the literature on the associations between alcohol use disorders (AUD) and major depression (MD), and to evaluate the evidence for the existence of a causal relationship between the disorders.

METHODS

PsycInfo; PubMed; Embase; Scopus; ISI Web of Science database searches for studies pertaining to AUD and MD from the 1980 to the present. Random-effects models were used to derive estimates of the pooled adjusted odds ratios (AOR) for the links between AUD and MD among studies reporting an AOR.

RESULTS

The analysis revealed that the presence of either disorder doubled the risks of the second disorder, with pooled AORs ranging from 2.00 to 2.09. Epidemiological data suggest that the linkages between the disorders cannot be accounted for fully by common factors that influence both AUD and MD, and that the disorders appear to be linked in a causal manner. Further evidence suggests that the most plausible causal association between AUD and MD is one in which AUD increases the risk of MD, rather than vice versa. Potential mechanisms underlying these causal linkages include neurophysiological and metabolic changes resulting from exposure to alcohol. The need for further research examining mechanisms of linkage, gender differences in associations between AUD and MD and classification issues was identified.

CONCLUSIONS

The current state of the literature suggests a causal linkage between alcohol use disorders and major depression, such that increasing involvement with alcohol increases risk of depression. Further research is needed in order to clarify the nature of this causal link, in order to develop effective intervention and treatment approaches.

Prevalence and Sociodemographic Correlates of Mental Health Problems Among Emergency Department Patients With High-Risk and Dependent Alcohol Use Patterns

OBJECTIVE

This study reports the prevalence of co-occurring mental health problems in a large convenience sample of emergency department (ED) patients with high-risk or dependent alcohol use patterns, as well as investigates associations between sociodemographic variables with co-occurring alcohol and mental health problems.

METHODS

Health educators screened adult patients from 12 large Southern California hospital ED/trauma units, collecting data about alcohol use behavior, sociodemographic data, and past 30-day problems with depression, anxiety, and cognitive function. Participants (N = 1,369) scored within either high-risk (hazardous, nondependent) or severe-risk (likely dependent) alcohol use categories. Analyses examined associations between age, sex, annual family income, employment status, and race/ethnicity with past 30-day mental health problems.

RESULTS

Overall, prevalence rates of 65%, 67%, and 50% were found for past 30-day problems with depression, anxiety, and cognitive function, respectively. Lower age was associated with anxiety problems only. Female gender was strongly associated with depression and anxiety. Higher income was associated with anxiety; lower income was associated with cognitive function problems. Employment status was strongly associated with all three mental health problems, with the unemployed having about double the risk of the employed. Race was associated with both depression and anxiety.

CONCLUSIONS

Results suggest that emergency department patients with high-risk drinking patterns experience high rates of depression, anxiety, and cognitive function problems. Vulnerable groups may be identified based on sociodemographic characteristics. Incorporating standardized screening for mental health problems in the emergency department may be appropriate, especially among those presenting with alcohol-related problems.