Sex and age differences in ED patients with mental and behavioral disorders due to psychoactive substance use.
OBJECTIVE
The objectives of this study are to describe an emergency department (ED) adult population with the chief complaint of mental and behavioral disorders due to psychoactive substance use and to investigate sex- and age-related differences.


METHODS
We analyzed data (2009-2011) from the Regional Observatory of Emergency Medicine ORU-MiP (700000 patients per year) for all patients with a primary diagnosis of mental and behavioral disorders due to psychoactive substance use. Day data were weighted by the number of days in the year and expressed for 100000 inhabitants of the area. Pearson χ(2) test and Fisher tests were used. The Brown-Mood test was used to compare medians.


RESULTS
Of the 1411597 ED visits analyzed, 20838 consults (1.3%) were for primary diagnosis of mental and behavioral disorders due to psychoactive substance use. The median age (interquartile range) was 41 (28-51) years; 69.5% were men. More women consulted the ED for sedative or hypnotic use (4.9% vs 1.5%, P < 10(-4)) than men, and more men consulted for alcohol consumption (93.5% vs 90%, P < 10(-4)) and cannabinoids (1.4% vs 1.0%, P < 10(-3)) than women. Young consumer visits dramatically increased during weekends (average of 88 visits a day per 100000 inhabitants vs 34 on Mondays to Thursdays). Another difference was found between young adults and middle-aged adults, with a peak in visits at 2 am and 9 pm respectively.


CONCLUSIONS
Mental and behavioral disorders due to psychoactive substance use account for 1.3% of ED visits. Older people should be screened for chronic alcohol consumption. Our findings underscore the opportunity provided by the ED for screening and brief intervention in drug- and alcohol-related problems.
Regional Observatory of Emergency Medicine in Midi-Pyrénées (ORU-MiP), Purpan University Hospital, Toulouse, France. Electronic address: lequerrec.f@orumip.fr.
Fanny
F
Le Querrec
Pharmacoépidémiologie, UMR1027, INSERM, Université de Toulouse III, Toulouse, France; Centre d'Évaluation et d'Information sur la Pharmacodépendance (Centre d'Addictovigilance), Service de Pharmacologie Clinique, Centre Hospitalier Universitaire, Toulouse, France; CHU Toulouse, Pôle de Médecine d'Urgences, Hôpital de Purpan, Toulouse, France.
Vincent
V
Bounes
Pharmacoépidémiologie, UMR1027, INSERM, Université de Toulouse III, Toulouse, France; Centre d'Évaluation et d'Information sur la Pharmacodépendance (Centre d'Addictovigilance), Service de Pharmacologie Clinique, Centre Hospitalier Universitaire, Toulouse, France.
Maryse Lapeyre
ML
Mestre
Regional Observatory of Emergency Medicine in Midi-Pyrénées (ORU-MiP), Purpan University Hospital, Toulouse, France.
Olivier
O
Azema
Regional Observatory of Emergency Medicine in Midi-Pyrénées (ORU-MiP), Purpan University Hospital, Toulouse, France.
Nicolas
N
Longeaux
Regional Observatory of Emergency Medicine in Midi-Pyrénées (ORU-MiP), Purpan University Hospital, Toulouse, France.
Jean-Christophe
JC
Gallart
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012189:Retrospective Studies; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
D011619:Psychotropic Drugs