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ERs Underdiagnosing Psychiatric Illness

Big gap between U.S. rates and emergency department records, study finds

MONDAY, Feb. 21, 2005 (HealthDay News) -- U.S. hospital emergency departments greatly underdiagnose psychiatric disorders, resulting in unnecessary suffering among patients, a new study finds.

Missing these diagnoses "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," the researchers wrote in the February issue of the Journal of Consulting and Clinical Psychology.

Investigators from Louisiana State University examined records on more than 33,000 patients at three hospital emergency departments in the South and Midwest United States. Those facilities recorded an overall psychiatric disorder rate among patients of 5.27 percent -- far below the national rate of 20 percent to 28 percent. The researchers believe this points to large numbers of missed diagnoses.

Specific differences between national and emergency department rates include:

  • Mood disorders: 4 percent (national rate) vs. 0.7 percent (emergency department rate)
  • Anxiety: 11 percent to 16 percent vs. 1.19 percent
  • Substance use disorders: 7 percent vs. 2.05 percent
  • Schizophrenia: 1.30 percent vs. 0.32 percent.

"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," the authors noted.

More information

The American Psychiatric Association outlines the warning signs of mental illness.

SOURCE: American Psychological Association, news release, Feb. 20, 2005
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