Purdue University, West Lafayette, IN, USA.
Duquesne University Counseling Services, Pittsburgh, PA, USA.
Health Promot Pract. 2024 Nov;25(6):1049-1057. doi: 10.1177/15248399231193005. Epub 2023 Aug 31.
The emergency department (ED) may be an optimal setting to screen for substance use disorders (SUDs) and co-occurring psychiatric disorders (CODs). We report on the frequency of problematic substance use and comorbid elevated mental health symptoms detected during a 1-year implementation period of an ED-based SUD/COD screening approach within an established ED HIV screening program.
Patients (N = 1,924) were approached by dedicated HIV screening staff in an urban, Midwestern ED. Patients first completed measures assessing problematic alcohol (Alcohol Use Disorder Identification Test-Concise [AUDIT-C]) and substance use across 10 categories of substances (National Institute on Drug Abuse-Modified Alcohol, Smoking, and Substance Involvement Screening Test [NIDA-Modified ASSIST]). Patients with positive alcohol and/or substance use screens completed measures assessing symptoms of depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and post-traumatic stress disorder (PTSD) (PTSD Checklist-Civilian [PCL-C]).
Patients were predominantly male (60.3%) with a mean age of 38.1 years (SD = 13.0); most identified as White (50.8%) or Black (44.8%). A majority (58.5%) had a positive screen for problematic alcohol and/or other substance use. Of those with a positive substance use screen (n = 1,126), 47.0% had a positive screen on one or more of the mental health measures with 32.1% endorsing elevated depressive symptoms, 29.6% endorsing elevated PTSD-related symptoms, and 28.5% endorsing elevated anxiety symptoms.
Among those receiving ED HIV screening, a majority endorsed problematic alcohol and/or other substance use and co-occurring elevated mental health symptoms. Substance use and mental health screening programs that can be integrated within other ED preventive services may enhance the identification of individuals in need of further assessment, referral, or linkage to substance use treatment services.
急诊科（ED）可能是筛查物质使用障碍（SUD）和共病精神障碍（COD）的最佳场所。我们报告了在 ED 内实施基于 ED 的 SUD/COD 筛查方法的 1 年期间，在既定的 ED HIV 筛查计划中，通过 ED 筛查方法检测到的物质使用问题和共病升高的心理健康症状的频率。
专门的 HIV 筛查工作人员在城市中西部 ED 中接触患者。患者首先完成了评估酒精问题（酒精使用障碍识别测试简明版 [AUDIT-C]）和十种物质使用的量表（国家药物滥用研究所修改的酒精、吸烟和物质参与筛查测试 [NIDA-Modified ASSIST]）。酒精和/或物质使用筛查阳性的患者完成了评估抑郁症状（患者健康问卷-9 [PHQ-9]）、焦虑症状（广泛性焦虑障碍-7 [GAD-7]）和创伤后应激障碍症状（创伤后应激障碍清单-平民版 [PCL-C]）的量表。
患者主要为男性（60.3%），平均年龄为 38.1 岁（SD=13.0）；大多数为白人（50.8%）或黑人（44.8%）。大多数（58.5%）存在酒精和/或其他物质使用问题的筛查阳性。在物质使用筛查阳性的患者中（n=1126），有 47.0%的患者在一项或多项心理健康量表上筛查阳性，其中 32.1%存在抑郁症状升高，29.6%存在创伤后应激障碍相关症状升高，28.5%存在焦虑症状升高。
在接受 ED HIV 筛查的患者中，大多数患者存在酒精和/或其他物质使用问题和共病升高的心理健康症状。可整合到其他 ED 预防服务中的物质使用和心理健康筛查计划可能会增强识别需要进一步评估、转介或与物质使用治疗服务联系的个体的能力。
