Emergency department and early detection of adolescents and young adults at risk of developing mental disorders: an exploratory study

  • Marco Solmi | marco.solmi83@gmail.com Neurosciences Department, University of Padua; Padua Neuroscience Center, University of Padua; Padua University Hospital, Psychiatry Unit, Padua, Italy; Early Psychosis: Interventions and Clinical Detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
  • Foscarina Della Rocca Padua University Hospital, Emergency Department, Padua, Italy.
  • Vito Cianci Padua University Hospital, Emergency Department, Padua, Italy.
  • Alessandro Giacometti Padua University Hospital, Emergency Department, Padua, Italy.
  • Chiara Alexopulos Padua University Hospital, Emergency Department, Padua, Italy.
  • Umberto Granziol Neurosciences Department, University of Padua; Padua Neuroscience Center, University of Padua; Padua University Hospital, Psychiatry Unit, Padua, Italy; Early Psychosis: Interventions and Clinical Detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Padua University Hospital, Emergency Department, Padua; Department of General Psychology, University of Padua, Padova, Italy. https://orcid.org/0000-0002-6286-6569
  • Angela Favaro Neurosciences Department, University of Padua; Padua Neuroscience Center, University of Padua; Padua University Hospital, Psychiatry Unit, Padua, Italy. https://orcid.org/0000-0002-6540-5194
  • Paolo Fusar-Poli Early Psychosis: Interventions and Clinical Detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
  • Miranda Zoleo Padua University Hospital, Emergency Department, Padua, Italy.
  • Carla Cremonese Padua University Hospital, Psychiatry Unit, Padua, Italy. https://orcid.org/0000-0003-3775-022X

Abstract

The objective of this study is to assess the potential role of Emergency Department (ED) for early detection of mental disorders. Two cohorts (6,759 subjects aged 14 to 24 accessing ED, 165 subjects with mental disorders) were matched by ID and merged. Primary outcome was the proportion of individuals accessing ED before receiving a diagnosis of mental disorder in Mental Health Service (MHS). Secondary outcomes were age of first access to ED in subjects later accessing to MHS, and time from first ED access to receiving a diagnosis of mental disorder at MHS. We assessed whether gender, severity of ED presentation, and number of ED accesses predicted primary outcome. Almost half of individuals who later developed mental disorders (49.7%) accessed ED before access to MHS. Mean age of first ED contact among those later accessing to MHS was 17.34 (2.1), and ED access preceded access to MHS by 3.68 (2.11) years. Gender and severity of ED presentation were not associated with the access to MHS, while higher number of ED accesses was associated with later access to MHS (OR range: 1.17-1.36, p<0.05). Despite its limitations, the present study suggests ED might represent a contact point for individuals who later access to MHS. Future early detection programs should involve ED in their outreach and screening approaches. Additional studies are needed to assess if subjects earlier accessing to ED are at risk-of-developing or already suffer from a mental disorder, and to validate screening instruments specifically designed for ED.

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Published
2020-09-18
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Keywords:
Mental disorders, early detection, prevention, emergency department, prediction, adolescent psychiatry, pathway to care
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How to Cite
Solmi, M., Della Rocca, F., Cianci, V., Giacometti, A., Alexopulos, C., Granziol, U., Favaro, A., Fusar-Poli, P., Zoleo, M., & Cremonese, C. (2020). Emergency department and early detection of adolescents and young adults at risk of developing mental disorders: an exploratory study. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(2). https://doi.org/10.4081/ripppo.2020.459