title: Methamphetamine-related psychiatric visits to an urban academic emergency department: an observational study.
abstract: BACKGROUND
  Methamphetamine, a stimulant of abuse, is associated with a significant number of Emergency Department (ED) visits. Methamphetamine use may produce psychiatric symptoms including acute psychosis, depression, and anxiety disorders.
  
  
  OBJECTIVE
  To characterize psychiatric emergencies either directly or indirectly attributable to methamphetamine use in an urban academic ED.
  
  
  METHODS
  We analyzed a database of patients determined to have an ED visit that was either methamphetamine related or non-methamphetamine related. We retrospectively reviewed the records of the subset of ED visits from this database with psychiatric diagnoses. We compared the characteristics of patients with methamphetamine-related psychiatric visits (MRPVs) and non-methamphetamine-related psychiatric visits (non-MRPVs).
  
  
  RESULTS
  We identified 130 patients with MRPVs. This represented 7.6% (130 of 1709) of all psychiatric visits. Patients with MRPV, compared to non-MRPV patients, were younger (34.4 years vs. 39.1 years, respectively, p = 0.0005), more likely to be uninsured (55% vs. 37%, respectively, p = 0.001), and less likely to have a past history of depression (10% vs. 19%, respectively, p = 0.011). Many characteristics between the two groups (MRPV vs. non-MRPV) were similar: likelihood of patient being placed on a psychiatric hold; hospital charges; previous histories of psychiatric visits; and history of anxiety, bipolar disorder, or schizophrenia.
  
  
  CONCLUSIONS
  Methamphetamine may be related to a significant proportion (7.6%) of psychiatric ED visits. Furthermore, patients with methamphetamine-associated psychiatric visits are younger, have lower rates of depression, are more likely to be uninsured, and are less likely to have a substance abuse-related chief complaint than patients with non-methamphetamine-associated ED psychiatric visits.
authors.affiliation: Department of Emergency Medicine, Oregon Health and Science University, Portland, Oregon 97239, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Cloutier
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hendrickson
authors.forename: Rongwei Rochelle
authors.initials: RR
authors.lastname: Fu
authors.forename: Brian
authors.initials: B
authors.lastname: Blake
mesh_terms: D000328:Adult; D000367:Age Factors; D019969:Amphetamine-Related Disorders / Q000150:complications; D001007:Anxiety / Q000139:chemically induced; D002637:Chest Pain / Q000139:chemically induced; D003863:Depression / Q000139:chemically induced; D004417:Dyspnea / Q000139:chemically induced; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006261:Headache / Q000139:chemically induced; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008694:Methamphetamine / Q000506:poisoning*; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D011605:Psychoses, Substance-Induced / Q000209:etiology; D012640:Seizures / Q000139:chemically induced; D059020:Suicidal Ideation; D019037:Urban Health Services / Q000706:statistics & numerical data*; D014839:Vomiting / Q000139:chemically induced; D014947:Wounds and Injuries / Q000139:chemically induced; D055815:Young Adult
chemical_list: D008694:Methamphetamine