title: Psychological distress in medical patients 30 days following an emergency department admission: results from a prospective, observational study.
abstract: Psychological distress in medical patients admitted to the emergency department (ED) is not well studied. Our aim was to investigate the extent of psychological distress in a broad and unselected medical patient sample 30 days after ED admission and its association with socio-demographic and clinical variables.
  
  
  
  We used data from a prospective observational cohort study including 1575 consecutive adult medical patients presenting to the ED with acute somatic conditions. Outcome variables were patient's psychological distress measured by the 4-item Patient Health Questionnaire (PHQ-4) and self-rated health assessed 30 days after ED admission using telephone interviews. Risk factors included socio-demographic variables (e.g. gender, marital status), clinical presentation (e.g. illness severity, main initial diagnosis) and course of illness (e.g. rehospitalisation, length of hospital stay).
  
  
  
  A total of 38 % of patients had evidence for psychological distress 30 days after ED admission. Multivariate analysis found female gender (adjusted odds ratio [aOR] 1.35, 95 % confidence interval [CI] 1.02 to 1.78), comorbid psychiatric disorder (aOR 1.63, 95 % CI 1.08 to 2.62), discharge to a post-acute care institution (aOR 1.47, 95 % CI 1.03 to 2.09), unplanned rehospitalisation (aOR 2.38, 95 % CI 1.47 to 3.86), and unplanned visit at general practitioner (aOR 4.75, 95 % CI 2.57 to 8.80) to be associated with distress at day 30 following ED admission.
  
  
  
  One month after ED admission a significant number of patients still show a moderate amount of psychophysical distress. Strongest related variables were course of illness, in particular unplanned general practitioner visits. Future interventional studies should assess possibilities to reduce distress in patients at increased risk.
  
  
  
  NCT01768494 , January 9, 2013 (registration date), February 25, 2013 (enrolment of first participant).
authors.affiliation: Institute of Psychology, University of Berne, Berne, Switzerland. lukas.faessler@gmx.net.|University Department of Internal Medicine, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Switzerland. lukas.faessler@gmx.net.
authors.forename: Lukas
authors.initials: L
authors.lastname: Faessler
authors.affiliation: University Department of Internal Medicine, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kutz
authors.affiliation: University Department of Internal Medicine, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Haubitz
authors.affiliation: University Department of Internal Medicine, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Switzerland.
authors.forename: Beat
authors.initials: B
authors.lastname: Mueller
authors.affiliation: Institute of Psychology, University of Berne, Berne, Switzerland.
authors.forename: Pasqualina
authors.initials: P
authors.lastname: Perrig-Chiello
authors.affiliation: University Department of Internal Medicine, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Switzerland.
authors.forename: Philipp
authors.initials: P
authors.lastname: Schuetz
mesh_terms: D000367:Age Factors; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*
keywords: Emergency patients; Psychological distress; Risk factors