Blamed and Shamed: The Treatment Experiences of Youth with Co-occurring Substance Abuse and Mental Health Disorders and Their Families

2001 ◽  
Author(s):  
◽  
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Mental Health Disorders ◽  
Health Disorders

Abstract 12679: Impact of Mental Health Disorders on Ventricular Assist Device Supported Patients Emergency Resource Use and Outcomes

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jonathan J Edwards ◽  
Jonathan Edelson ◽  
Hannah Katcoff ◽  
Antara Mondal ◽  
Debra Lefkowitz ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Substance Abuse ◽  
Resource Use ◽  
Mental Health Disorders ◽  
Primary Diagnosis ◽  
Lower Mortality ◽  
Admission Rates ◽  
Self Harm ◽  
Health Disorders

Introduction: There are minimal data describing the prevalence of mental health disorders (MHDO) in VAD-supported patients, or the association between MHDO and resource use or outcomes. Methods: This retrospective analysis utilizes all emergency department (ED) encounter-level data from the 2010-2017 Nationwide Emergency Department Sample (NEDS). Patients with VADs were identified using ICD-9/10 codes, as were associated MHDO diagnoses, which were categorized as depression/anxiety, suicide/self harm, bipolar/psychoses, and substance abuse. Outcomes and characteristics were compared for patients with and without a MHDO via descriptive statistics. Hospital admission and mortality occurring in ED or inpatient was investigated with logistic multivariable regression models adjusted for demographic and clinical characteristics. Results: Of the 47,543 encounters with VADs during the study period, 23% (n=11,103) had at least one MHDO. Depression/anxiety (82%) and substance abuse (22%) were the most prevalent MHDOs. Suicide attempt or self harm was the primary diagnosis for 20 (0.2%) encounters. Patients with MHDOs were more likely to be female (31% vs. 26%), younger (median age 59 vs. 61 years), and to have a non-MHDO chronic condition (77% vs 70%, P<0.0001 for all). Inpatient admission rates (79% vs. 59%) and charges ($33,421 (95% CI 15,074-73,517) vs. $21,346 (95% CI 5,290-56,910) were higher for those with MHDOs (both p<0.0001, Figure). However, mortality (2.0% vs. 3.3%, p=0.003) was lower. After adjusting for age, gender, and non-MHDO diagnoses, patients with MHDOs had higher admission rates (OR 2.3 (95% CI 1.8-2.9), p<0.001) and lower mortality (OR 0.63 (95% CI 0.42-0.94), p=0.03). Discussion: 1 in 5 VAD-supported ED patient encounters also have a MHDO diagnosis. VAD-supported patients with a MHDO had higher resource use but lower mortality. These data underscore the need for greater attention to how MHDO may impact outcomes in VAD-supported patients.

Youth with substance abuse and comorbid mental health disorders

2008 ◽  
Vol 10 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Christopher A. Lamps ◽  
Aradhana B. Sood ◽  
Rishi Sood
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Mental Health Disorders ◽  
Health Disorders
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