title: Depression is associated with repeat emergency department visits in patients with non-specific abdominal pain.
abstract: BACKGROUND
  Patients with abdominal pain often return multiple times despite no definitive diagnosis. Our objective was to determine if repeat emergency department (ED) use among patients with non-specific abdominal pain might be associated with a diagnosis of moderate to severe depressive disorder.
  
  
  METHODS
  We screened 987 ED patients for major depression during weekday daytime hours from June 2011 through November 2011 using a validated depression screening tool, the PHQ-9. Each subject was classified as either no depression, mild depression or moderate/severe depression based on the screening tool. Within this group, we identified 83 patients with non-specific abdominal pain by either primary or secondary diagnosis. Comparing depressed patients versus non-depressed patients, we analyzed demographic characteristics and number of prior ED visits in the past year.
  
  
  RESULTS
  In patients with non-specific abdominal pain, 61.9% of patients with moderate or severe depression (PHQ9≥10) had at least one visit to our ED for the same complaint within a 365-day period, as compared to 29.2% of patients with no depression (PHQ9<5), (p=0.013).
  
  
  CONCLUSIONS
  Repeat ED use among patients with non-specific abdominal pain is associated with moderate to severe depressive disorder. Patients with multiple visits for abdominal pain may benefit from targeted ED screening for depression. [West J Emerg Med. 2014;15(3):325-328.].
authors.affiliation: George Washington University, Department of Emergency Medicine, Washington, District of Columbia.
authors.forename: Andrew Charles
authors.initials: AC
authors.lastname: Meltzer
authors.affiliation: George Washington University, Department of Psychiatry, Washington, District of Columbia.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bregman
authors.affiliation: George Washington University, Department of Emergency Medicine, Washington, District of Columbia.
authors.forename: Janice
authors.initials: J
authors.lastname: Blanchard
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000523:psychology*; D000328:Adult; D017677:Age Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008484:Medicaid; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors; D014481:United States / Q000453:epidemiology