Featured Research

from universities, journals, and other organizations

Psychiatric Disorders Greatly Underdiagnosed In Hospital Emergency Departments

Date:
March 8, 2005
Source:
American Psychological Association
Summary:
New research offers dramatic evidence of how psychiatric disorders are underdiagnosed in hospital emergency departments, affecting an increasing number of Americans who rely on such facilities for much of their primary health care needs.

WASHINGTON -- New research offers dramatic evidence of how psychiatric disorders are underdiagnosed in hospital emergency departments, affecting an increasing number of Americans who rely on such facilities for much of their primary health care needs. The research appears in this month's issue of the Journal of Consulting and Clinical Psychology, published by the American Psychological Association (APA).

In their study involving more than 33,000 Caucasian and African American patients from three hospital emergency departments in the Midwest and South, psychologist Seth Kunen, Ph.D., Psy.D., from the Earl K. Long Medical Center and the Louisiana State University Emergency Medicine Residency Program and colleagues confirm earlier reports that a significant psychiatric underdiagnosis is taking place. The researchers observed a psychiatric rate of 5.27% among the emergency department patients, a rate far below the national prevalence rate of 20% to 28%.

Comparing national rates of various psychiatric disorders versus the observed emergency department rates, the researchers found the following:

# mood disorders= 4% (national rate) versus 0.70% (emergency department rate)

# anxiety= 11-16% versus 1.19%

# substance use disorders = 7% versus 2.05%

# tobacco use disorder= 25% versus .23%

# organic psychosis (psychosis due to brain injury or disease)= diagnostic ratios ranging from 3:1 to 25:1 depending on age group and method of estimation

# schizophrenia= 1.30% versus 0.32%

Both Caucasians and African Americans were underdiagnosed in the emergency departments, but the study found a much larger underdiagnosis for African Americans. The odds of Caucasians having a psychiatric diagnosis were 1.85 times that of African Americans and almost twice as many Caucasians as African Americans received a psychiatric diagnosis as the primary diagnosis. The researchers say there are several possible reasons for this disparity, including Caucasian physicians being more familiar with the mental disorder symptoms of Caucasians, the tendency of African Americans to be less trusting and less willing to disclose emotional problems to people of different racial groups, and physician bias.

The authors say it is possible that African Americans simply have fewer psychiatric disorders than Caucasians and that is the reason for the race disparity. "However, because a much greater percentage of African Americans live in poverty than Caucasians and because there are strong correlations among variable such as poverty and illness, it would be more reasonable to expect the rate of psychiatric disorders among African Americans to be as high or higher than the rate among Caucasians," according to the authors. The authors also note that the observed race disparity may be limited to emergency departments that have a predominantly African American census.

To get a better understanding of the underdiagnosis phenomenon, the researchers conducted informal interviews with more than 50 emergency department physicians. The physicians cited lack of psychiatric expertise, a belief that many mental disorders are relatively unimportant threats to health, and the inability to provide continuity of care for their patients as major reasons that may contribute to underdiagnosis.

As emergency medicine moves from its historical origin as a trauma specialty to its developing role as a primary care provider for millions of people each year, the researchers say it's imperative that emergency departments expand their staffs to include mental health professionals such as psychologists because hospital-based physicians may not have the training, interest, or time to deal with mental health issues.

"The psychiatric underdiagnosing we have documented is potentially the most damaging for the more vulnerable minorities and the poor who rely on emergency departments for much of their primary health care needs," say the authors. "This underdiagnosing contributes to needless emotional suffering because many of the more common disorders, such as depression and anxiety, respond well to psychotherapy and pharmacological interventions."

###

Article: "Race Disparities in Psychiatric Rates in Emergency Departments," Seth Kunen, Earl K. Long Medical Center, Ronda Niederhauser, Regional West Medical Center, Patrick O. Smith, University of Mississippi School of Medicine, Jerry A. Morris, Nevada Mental Health Services, and Brian D. Marx, Louisiana State University; Journal of Consulting and Clinical Psychology, Vol. 73, No. 1.


Story Source:

The above story is based on materials provided by American Psychological Association. Note: Materials may be edited for content and length.


Cite This Page:

American Psychological Association. "Psychiatric Disorders Greatly Underdiagnosed In Hospital Emergency Departments." ScienceDaily. ScienceDaily, 8 March 2005. <www.sciencedaily.com/releases/2005/02/050224105821.htm>.
American Psychological Association. (2005, March 8). Psychiatric Disorders Greatly Underdiagnosed In Hospital Emergency Departments. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2005/02/050224105821.htm
American Psychological Association. "Psychiatric Disorders Greatly Underdiagnosed In Hospital Emergency Departments." ScienceDaily. www.sciencedaily.com/releases/2005/02/050224105821.htm (accessed July 25, 2014).

Share This




More Mind & Brain News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

AFP (July 24, 2014) A so-called drugs rehab 'clinic' is closed down in Pakistan after police find scores of ‘patients’ chained up alleging serial abuse. Duration 03:05 Video provided by AFP
Powered by NewsLook.com
New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Can Watching TV Make You Feel Like A Failure?

Can Watching TV Make You Feel Like A Failure?

Newsy (July 24, 2014) A study by German researchers claims watching TV while you're stressed out can make you feel guilty and like a failure. Video provided by Newsy
Powered by NewsLook.com
China's Ageing Millions Look Forward to Bleak Future

China's Ageing Millions Look Forward to Bleak Future

AFP (July 24, 2014) China's elderly population is expanding so quickly that children struggle to look after them, pushing them to do something unexpected in Chinese society- move their parents into a nursing home. Duration: 02:07 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile: iPhone Android Web
          Follow: Facebook Twitter Google+
          Subscribe: RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins