Frequency, Prevalence, Interaction, and Gender Differences of Six Psychosocial Factors in Patients Presenting to a Psychiatric Emergency Service.

Introduction: The psychiatric emergency service (PES) has become an increasingly utilized patient care approach over the past 50 years. Psychosocial factors play an important role in PES utilization and disposition of patients in this environment. PES utilization in our region has increased 450% in the past 18 years, while the population has changed <1%. Our objective was to determine the frequency and relationship between six psychosocial factors in our patients, in comparison to the general population.

Methods: We completed a retrospective chart review of 160 patients selected at random who utilized the PES during 2009-2010. We looked for historical presence of a broken family, abuse or neglect, substance abuse, legal problems, violence, or incomplete education. We also looked at the relationship of these factors to race and gender.

Results: 75% had three or more of the factors measured. In our population, substance abuse and broken family were most prevalent. Females had significantly more abuse or neglect as compared to males, while male subjects had significantly more substance abuse and legal issues than females. The presence of a broken family was strongly associated with abuse or neglect, while violence was associated with incomplete education and legal issues. The prevalence of these factors in our patients was higher than the general population.

Conclusion: The average patient presenting to the PES has multiple major psychosocial problems at higher frequencies than the general population. Understanding the relationship between multiple psychosocial factors and increasing PES utilization can direct us towards addressing the problems causing the increase in PES presentation. A planned future prospective study will examine the incidence of these psychosocial factors in patients presenting to the PES as compared to the general population.