Somatic symptoms and level of anxiety and depression in self-referral patients at the emergency department

• Autorzy: Lisowska A. , Szwamel K. , Kurpas D.
• Języki publikacji: EN

Abstrakty

EN

Background: Due to multiple morbidities, patients experience various symptoms that may be of psychogenic or somatic origin. Anxiety and depression can induce somatization and the feeling that ailments require urgent medical intervention. Aim of the study: This study aimed to: (1) identify which symptoms self-referral patients most commonly report at the emergency department (ED) and which medical diagnoses they are discharged with; and (2) determine whether the type and severity of symptoms, as well as, sociodemographic variables are related to anxiety and depression levels. Material and methods: The study included 110 patients who self-referred to the ED at the University Clinical Hospital in Opole. Diagnostic surveys and questionnaires were used, including the Hospital Anxiety and Depression Scale and an original questionnaire developed by the authors. Results: Among those suffering from chronic diseases (n = 53; 48.62%), 12 patients (22.64%) did not complete a single visit to the PHCF (Primary Health Care Facility), and 30 patients (56.60%) did not complete a visit to OSC (Outpatient Specialist Care) during the previous 12 months. The most common cause of reporting to the ED were pain and a burning sensation in the chest (n = 29; 27.10%). During discharge, the most common diagnosis was “other chest pains” (n = 22; 20.00%). 82.73% (n = 91) of patients had clear anxiety disorders, and 68.18% (n = 75) had clear depressive disorders. Conclusions: In case of somatic symptoms without a discernible cause in patients, it is necessary to implement comprehensive measures within PHCF, such as periodic measurements of anxiety and depression severity, psychological consultation, and an in-depth medical interview. These data also suggest that proper clinical monitoring should be implemented, including clinical parameters relevant for chronic diseases and the number of visits to the PHCF and OSC.

• Wydawca: -
• Czasopismo: Medical Science Pulse
• Rocznik: 2020
• Tom: 14
• Numer: 1
• Opis fizyczny: p.21-30,ref.

Twórcy

autor

Lisowska A.

• Emergency Department, Opole University Hospital, Opole, Poland

autor

Szwamel K.

• Opole Medical School, Opole, Poland

autor

Kurpas D.

• Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland

Bibliografia

• 1. Newton MF, Keirns CC, Cunningham R, Hayward RA, Stanley R. Uninsured adults presenting to US emergency departments: assumptions vs data. JAMA 2008 Oct 22; 300(16): 1914–1924.
• 2. Moffat K, Mercer SW. Challenges of managing people with multimorbidity in today’s healthcare system. BMC Family Practice 2015; 16: 129.
• 3. Markun S, Holzer B, Rodak R, Kaplan V, Wagner C, Battegay E, et al. Therapeutic conflicts in Emergency Department Patients with multimorbidity: a cross sectional study. Plos One 2014; 9(10): 1–9.
• 4. Sarnak D, Ryan J. How high-need patients experience the health care system in nine countries. The Commonwealth Fund 2016: 1–14 [online] [cit. 27.12.2019]. Available from URL: https://www.commonwealthfund.org/publications/issue-briefs/2016/jan/how-high-need-patients-experience-health-care-system-nine.
• 5. Leutgeb R, Berger S, Szecsenyi J, Laux G. Patients with somatoform disorders: more frequent attendance and higher utilization in primary Out-of-Hours care? PLoS ONE 13(8): e0202546 [online] [cit. 27.12.2019]. Available from URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202546.
• 6. Cozzi G, Barbi E. Facing somatic symptom disorder in the emergency department. J Paediatr Child Health 2019 Jan; 55(1): 7–9.
• 7. Abar B, Hong S, Aaserude E, Holub A, DeRienzo V. Access to care and depression among emergency department patients. Emerg Med 2017; 53(1): 30–37.
• 8. Rodriguez González AM, Ramírez Aranda JM, de Los Santos Reséndiz H, Lara Duarte MY, Pazaran Zanella SO, Méndez López JF, et al. Health care utilization of Mexican patients with medically unexplained physical symptoms. Colomb Med (Cali) 2016 Sep 30; 47(3): 155–159.
• 9. Poloni N, Ielmini M, Caselli I, Ceccon F, Bianchi L, Isella C, et al. Medically unexplained physical symptoms in hospitalized patients: a 9-year retrospective observational study. Front Psychiatry 2018 Nov 23; 9: 626 [online] [cit. 27.12.2019]. Available from URL: https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00626/full.
• 10. Jadhakhan F, Lindner OC, Blakemore A, Guthrie E. Prevalence of medically unexplained symptoms in adults who are high users of health care services: a systematic review and meta-analysis protocol. BMJ Open 2019 Jul 2; 9(7): e027922 [online] [cit. 27.12.2019]. Available from URL: https://bmjopen.bmj.com/content/9/7/e027922.
• 11. Marzilli E. Somatoform symptoms in adolescents who visit the emergency department: alexithymia and defensive strategies. EpSBS 2017; 24: 257–266.
• 12. Alsma J, Wouw JV, Jellema K, Coffeng SM, Tobback E, Delesie L, et al. Medically unexplained physical symptoms in patients visiting the emergency department: an international multicentre retrospective study. Eur J Emerg Med 2019 Aug; 26(4): 249–254.
• 13. Shindhaye R, Mendenhall E, Sumathipala K, Sumathipala A, Patel V. Association of somatoform disorders with anxiety and depression in women in low and middle income countries: a systematic review. Int Rev Psychiatry 2013 Feb; 25(1): 65–76.
• 14. Lieb R, Meinlschmidt G, Araya R. Epidemiology of the association between somatoform disorders and anxiety and depressive disorders: an update. Psychosom Med 2007; 69: 860–863.
• 15. Sporinova B, Manns B, Tonelli M, Hemmelgarn B, Macmaster F, Mitchell N, et al. Association of mental health disorders with healthcare utilization and costs among adults with cronic disease. JAMA Netw Open 2019; 2(8): e199910 [online] [cit. 27.12.2019]. Available from URL: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2748662.
• 16. Polikandrioti M, Gouvenos I, Michalis L, Patsilinakos S, Nikolaou V, Olympios C, et al. The effects of anxiety and depression on the needs of patients hospitalized with coronary disease. Arch Hell Med 2012; 29: 33–34.
• 17. Rekleiti M, Roupa Z, Kyriazis I, Wozniak G, Kyloydis P, Souliotis K. Self-assessment of depression in patients with diabetes mellitus and its correlation with complications. Arch Hell Med 2012; 29: 599–605.
• 18. Willgoss TG, Yohannes AM. Anxiety disorders in patients with COPD: a systematic review. Respir Care 2013; 58: 858–866.
• 19. Hoyer D, David E. Screening for depression in emergency department patients. J Emerg Med 2012 Nov; 43(5): 786–789.
• 20. Beiser DG, Ward CE, Vu Ma M, Leiteerapong N, Gibbons R. Depression in emergency department patients and association with healthcare utilization. Acad Emerg Med 2019; 26(8): 878–888.
• 21. Wells K, Craven P, Steenblik J, Carlson M, Cooper C, Madsen T. Prevalence and treatment of anxiety among emergency department patients with pain. Am J Emerg Med 2018 Jul; 36(7): 1315–1317.
• 22. Craven P, Cinar O, Madsen T. Patient anxiety may influence the efficacy of ED pain management. Am J Emerg Med 2013 Feb; 31(2): 313–318.
• 23. Leander M, Lampa E, Rask-Andersen A, Franklin K, Gislason T, Oudin A, et al. Impact of anxiety and depression on respiratory symptoms. Respir Med 2014 Nov; 108(11): 1594–1600.
• 24. Lee K, Johnson MH, Harris J, Sundram F. The resource utilization of medically unexplained medical symptoms. SAGE Open Med 2016; 4: 2050312116666217.
• 25. Andersen NL, Eplov LF, Andersen JT, Hjorthoj CR, BirketSmith M. Health care use by patients with somatoform disorders: a registered-based follow up study. Psychosomatics 2013 MarApr; 54(2): 132–141.
• 26. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361–370.
• 27. Majkowicz M. Praktyczna ocena efektywności opieki paliatywnej – wybrane techniki badawcze. In: de Walden-Gałuszko K, Majkowicz M. Ocena jakości opieki paliatywnej w teorii i praktyce. Gdańsk: Akademia Medyczna; 2000: 21–42. (In Polish).
• 28. Hinkle DE, Wiersma W, Jurs SG. Applied statistics for the behavioral sciences. 5th ed. Boston: Houghton Mifflin; 2003.
• 29. R Core Team (2019). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria [cit. 27.12.2019]. Available from URL: https://www.r-project.org/index.html.
• 30. Sadillioglu S, Topacoglu H, Dikme O, Erdede MO, Ozyuvaci E, Dikme O. Patients do actually know? Evaluation of patients perception regarding their disease severity in the Emergency Department. International Medical Journal 2013; 20(6): 1–4.
• 31. Barometr WHC. Raport na temat zmian w dostępności do gwarantowanych świadczeń zdrowotnych w Polsce nr 19/15/02/2019. Stan na grudzień/styczeń 2019 r. Warszawa [online] 2019 [cit. 24.12.2019]. Available from URL: http://www.korektorzdrowia.pl/wp-content/uploads/barometr_whc_xii_i_2019_final.pdf. (In Polish).
• 32. CBOS. Komunikat z badań Nr 89/2018. Opinie na temat funkcjonowania opieki zdrowotnej [online] 2018 [cit. 24.12.2019]. Available from URL: https://cbos.pl/SPISKOM.POL/2018/K_089_18.PDF. (In Polish).
• 33. World Health Organization. Depression and other common mental disorders. WHO/MSD/MER/2017.2: 1–24 [online] [cit. 27.12.2019]. Available from URL: https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf.
• 34. Fogarty C, Sharma S, Chetty V, Culpepper L. Mental health conditions are associated with increased health care utilization among urban family medicine patients. J Am Board Fam Med 2008; 21(5): 398–407.
• 35. Al Aseri Z, Suriya MO, Hassan HA, Hasan M, Sheikh SA, Al Tamimi A, et al. Reliability and validity of the hospital anxiety and depression scale in an emergency department in Saudi Arabia: a cross-sectional observational study. BMC Emerg Med 2015 Oct 12; 15: 28.
• 36. Nowicka-Sauer K, Pietrzykowska M, Staśkiewicz I, Ejdys M, Czuszyńska Z, Molisz A, et al. Lęk u pacjentów z chorobami przewlekłymi: istotny a marginalizowany problem. Fam Med and Prim Care Rev 2015; 17(2): 120–123. (In Polish).
• 37. Soares-Filho GL, Freire RC, Biancha K, Pacheco T, Volschan A, alenca AM, et al. Use of hospital anxiety and depression scale (HADS) in a cardiac emergency room chest pain unit. Clinics 2009; 64: 209–214.
• 38. Srinivasan K, Joseph W. A study of lifetime prevalence of anxiety and depressive disorders in patients presenting with chest pain to emergency medicine. Gen Hosp Psychiatry 2004; 26: 470–474.
• 39. Croicu C, Chwastiak L, Katon W. Approach to the patient with multiple somatic symptoms. Med Clin North Am 2014; 98: 1079–1095.
• 40. Hsia R, Niedzwiecki M. Avoidable emergency department visits: a starting point. International for Quality in Health Care 2017; 29(5): 642–645.
• 41. Lubszczyk M, Pietrus M, Sulewski M, Gajecki K, Styka L. Emerytura na SORze – analiza przyczyn hospitalizacji osób po 65 roku życia w szpitalnym oddziale ratunkowym. Geriatria 2014; 8: 93–101. (In Polish).
• 42. Salsberry PJ, Chipps E, Kennedy C. Use of general medical services among patients with severe and persistent mental illness. Psychiatr Serv 2005; 56(4): 458–462.
• 43. Dark T, Flynn H, Rust G, Kinsell H, Harman J. Epidemiology of emergency department visits for anxiety in the United States: 2009–2011. Psychiatr Serv 2017; 68(3): 238–244.
• 44. Weiss A, Barrett ML, Heslin KC, Stocks C. Trends in emergency department visits involving mental and substance use disorders 2006–2013. HCUP Statistical Brief Nr 216 [online] 2016 Dec [cit. 27.12.2019]. Available from URL: https://hcup-us.ahrq.gov/reports/statbriefs/sb216-Mental-Substance-Use-DisorderED-Visit-Trends.pdf.
• 45. Uchmanowicz I, Gobbens RJJ. The relationship between frailty, anxiety and depression and health-related quality of life in elderly patients with heart failure. Clinical Interventions in Aging 2015; 10: 1595–1600.
• 46. Aoun A, Al Hayek S, El Jabbour F. The need for new model of the physician – patient relationship” a challenge for modern medical practice. Fam Med and Prim Care Rev 2018; 20(4): 379–384.
• 47. Pfizer. Patient Health Questionnaire (PHQ) Screeners (online) (cit. 27.12.2019). Available from URL: https://www.phqscreeners.com/select-screener.
• 48. Parnowski T, Jernajczyk W. Inwentarz Depresji Becka w ocenie osób zdrowych i chorych na choroby afektywne (ocena pilotażowa). Psychiatr Pol 1977; 11: 417–421. (In Polish).
• 49. Sosnowski T, Wrześniewski K. Research with the Polish form of the State-Trait Anxiety Inventory. In: Spielberger CD, DiazGuerrero R, eds. Cross-cultural anxiety. New York: Hemisphere/Harper and Row; 1986.

Identyfikatory

DOI

10.5604/01.3001.0014.0685