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Screening for alcohol misuse among emergency department patients may uncover depression

Screening for alcohol misuse in the emergency room (ED) may provide patients with early evaluation, prevention, and treatment of depression, which may otherwise go undetected, suggests a new study. It found that a group of mostly Hispanic and black young adults seeking care at an urban ED were about twice as likely to suffer depressive symptoms if they had problems misusing alcohol.

The researchers examined the association between four levels of alcohol misuse (at-risk drinking, problem drinking, alcohol abuse, and binge drinking) and recent depressive symptoms among a random sample of 412 adults seen at the ED. Half of these patients (51 percent) reported depressive symptoms during the past week on a 20-item depression scale, such as loss of appetite, lack of energy, and crying spells. This rate is twice that of depressive symptoms in the general adult population (24 percent). More than one-fourth of the group (26 percent) reported at-risk drinking, 28 percent scored positive on an alcohol problem screen, 25 percent reported alcohol abuse, and 28 percent reported binge drinking.

Patients with at-risk drinking, problem drinking, drinking abuse, and binge drinking were 2.5, 2.1, 2.6, and 1.9 times more likely to have suffered depressive symptoms in the past week. Other factors strongly linked to depressive symptoms were being male, having less than a high school education, being unemployed, and being younger.

The study was supported in part by the Agency for Healthcare Research and Quality (HS14022). More details are in "Alcohol misuse and report of recent depressive symptoms among ED patients," by Shahrzad Bazargan-Hejazi, Ph.D., Mohsen Bazargan, Ph.D., Tommie Gaines, M.D., and Michael Jemanez, M.D., in the American Journal of Emergency Medicine 26, pp. 537-544, 2008.

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