title: Major depression and recent physical or sexual abuse increase readmissions among high-utilising primary care patients.
abstract: Objective To investigate whether current major depression and past physical/sexual victimisation is associated with recurrent general hospital admissions.Method Ninety-six inner-city primary care patients with a history of high medical service utilisation completed the PRIME-MD and the Abuse Assessment Screen; medical records were reviewed to assess reasons for re-hospitalisations. We compared hospitalisation rates over the preceding 12 months between those subjects with and without major depression and those with and without histories of abuse.Results Compared to non-abused subjects, patients with past-year abuse showed significantly increased past-year hospitalisations (3.2 versus 1.8, P = 0.007). Re-admissions were related to chronic disease management and were not because of acute physical effects of trauma. Analysis of variance revealed that major depressive disorder and past-year abuse history interacted to increase an association with re-admissions.Conclusions Past-year abuse was independently associated with increased hospital admissions. Psychological effects of recent abuse combined with depression may particularly increase rates of medical/surgical hospitalisations.
authors.affiliation: Chairman, Bronx-Lebanon Hospital Center and Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Levine
authors.forename: Karen E
authors.initials: KE
authors.lastname: Brown
authors.forename: Marek
authors.initials: M
authors.lastname: Chawarski
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
authors.forename: William D
authors.initials: WD
authors.lastname: White
authors.forename: William H
authors.initials: WH
authors.lastname: Sledge