title: Depression, suicidal ideation, and suicidal attempt presenting to the emergency department: differences between these cohorts.
abstract: BACKGROUND
  The World Health Organization estimates that one million people die by suicide every year. Few studies have looked at factors associated with disposition in patients with chief complaints of depression, suicidal ideation (SI) and suicidal attempts (SA) who present to the emergency department (ED). Our objective was to assess individual determinants associated with ED disposition of patients in depressed patients presenting to the ED.
  
  
  METHODS
  We conducted a retrospective study using the National Hospital Ambulatory Medical Care Survey from 2006 to 2008. We used logistic regression to identify factors associated with discharge, in SI, SA and depression patients. Independent variables included socio-demographic information, vital signs, mode of arrival, insurance status, place of residence and concomitant psychiatric diagnosis.
  
  
  RESULTS
  Of the 93,030 subjects, 2,314 met the inclusion criteria (1,362 depression, 353 SI and 599 SA). Patients who arrived by ambulance were less likely to be discharged (odds ratio [OR] 0.63, 95% confidence interval [CI] 0.43-0.92). Hispanic patients and patients age 15 to 29 were likely to be discharged (OR 1.61, 95% CI 1.16-2.24 and OR 1.55, 95% CI 1.15-2.10 respectively). Insurance status and housing status were not significantly associated patient was being discharge from EDs.
  
  
  CONCLUSIONS
  The Hispanic population had higher discharge rates, but the reasons are yet to be explored. Patients with SA and SI are discharged less frequently than those with depression, regardless of insurance type or housing status.
authors.affiliation: University of California Irvine, School of Medicine, Department of Emergency Medicine, Irvine, California.
authors.forename: Bharath
authors.initials: B
authors.lastname: Chakravarthy
authors.affiliation: University of California Irvine, School of Medicine, Department of Emergency Medicine, Irvine, California.
authors.forename: Wirachin
authors.initials: W
authors.lastname: Hoonpongsimanont
authors.affiliation: University of California Irvine, School of Medicine, Department of Emergency Medicine, Irvine, California.
authors.forename: Craig L
authors.initials: CL
authors.lastname: Anderson
authors.affiliation: University of California Irvine, School of Medicine, Department of Emergency Medicine, Irvine, California.
authors.forename: Michael
authors.initials: M
authors.lastname: Habicht
authors.affiliation: University of California Irvine, School of Medicine, Department of Emergency Medicine, Irvine, California.
authors.forename: Tim
authors.initials: T
authors.lastname: Bruckner
authors.affiliation: University of California Irvine, School of Medicine, Department of Emergency Medicine, Irvine, California.
authors.forename: Shahram
authors.initials: S
authors.lastname: Lotfipour
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D003863:Depression / Q000453:epidemiology* / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D012189:Retrospective Studies; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult