Unsuspected or unacknowledged depressive symptoms in young adult emergency department patients.
OBJECTIVE
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.
Biros
Michelle H
MH
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA. Biros001@umn.edu
Mann
Jessica
J
Hanson
Rebecca
R
Cen
Ye Ying
YY
D000293:Adolescent; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012647:Self-Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult