Comorbid psychiatric disorders and alcohol-related injury among adolescents and young adults treated in emergency departments

Thomas M. Kelly, Tammy Chung, John E. Donovan, Oscar G. Bukstein, Jack R. Cornelius, Ihsan M Salloum

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: To investigate the prevalence and comorbidity of psychiatric disorders among 12-20 year-old patients treated in emergency departments. Methods: Two hundred-fifteen adolescents and young adults were recruited on weekends from two Level-1 trauma facilities located within a University-based medical center. Comprehensive psychiatric interviews were conducted with participants outside the emergency department. Latent class analysis was used to determine participant clusters based on DSM-IV psychiatric diagnoses and emergency treatment for an alcohol-related medical event as indicator variables, while controlling for covariates. Results: A three-cluster model: (1) n = 90, 42%; (2) n = 65, 31%; and (3) n = 57 (27%) provided the best fit to the data. None of the participants in Cluster 1 were treated for alcohol-related events. All members of Cluster 2 were treated for alcohol-related events but only 23% were diagnosed with an alcohol use disorder. Thirty-two members of Cluster 3 (56%) were treated for alcohol-related events and Cluster 3 members were significantly higher than members of Clusters 1 and 2 on rates of: (1) alcohol use disorders (Wald statistic = 30.1, p < .001), (2) drug use disorders (Wald statistic = 42.3, p < .001), and 3) disruptive behavior disorders (Wald statistic = 19.3, p < .001). Conclusions: One group treated in the ED in this study is at low risk for alcohol-related injury. Conversely, one at risk-group may require brief interventions of low intensity while the other at-risk group displays high rates of comorbid psychiatric disorders and frequently engages in risk-taking behaviors, placing them at highest-risk for experiencing alcohol- related injuries. Reduction of alcohol-related injuries in young drinkers depends on differentiating high and low risk drinkers in the emergency department and providing, or referring them to appropriate treatment.

Original languageEnglish
Pages (from-to)27-46
Number of pages20
JournalJournal of Dual Diagnosis
Volume2
Issue number1
DOIs
StatePublished - Mar 1 2006
Externally publishedYes

Fingerprint

Alcohol-Related Disorders
Psychiatry
Hospital Emergency Service
Young Adult
Alcohols
Wounds and Injuries
Attention Deficit and Disruptive Behavior Disorders
Emergency Treatment
Risk-Taking
Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Substance-Related Disorders
Comorbidity

Keywords

  • Adolescent
  • Alcohol-related injury
  • Emergency department
  • Latent class analysis
  • Psychiatric disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Comorbid psychiatric disorders and alcohol-related injury among adolescents and young adults treated in emergency departments. / Kelly, Thomas M.; Chung, Tammy; Donovan, John E.; Bukstein, Oscar G.; Cornelius, Jack R.; Salloum, Ihsan M.

In: Journal of Dual Diagnosis, Vol. 2, No. 1, 01.03.2006, p. 27-46.

Research output: Contribution to journalArticle

Kelly, Thomas M. ; Chung, Tammy ; Donovan, John E. ; Bukstein, Oscar G. ; Cornelius, Jack R. ; Salloum, Ihsan M. / Comorbid psychiatric disorders and alcohol-related injury among adolescents and young adults treated in emergency departments. In: Journal of Dual Diagnosis. 2006 ; Vol. 2, No. 1. pp. 27-46.
@article{5269f878ea7b4689a9f8389cfac524fc,
title = "Comorbid psychiatric disorders and alcohol-related injury among adolescents and young adults treated in emergency departments",
abstract = "Objectives: To investigate the prevalence and comorbidity of psychiatric disorders among 12-20 year-old patients treated in emergency departments. Methods: Two hundred-fifteen adolescents and young adults were recruited on weekends from two Level-1 trauma facilities located within a University-based medical center. Comprehensive psychiatric interviews were conducted with participants outside the emergency department. Latent class analysis was used to determine participant clusters based on DSM-IV psychiatric diagnoses and emergency treatment for an alcohol-related medical event as indicator variables, while controlling for covariates. Results: A three-cluster model: (1) n = 90, 42{\%}; (2) n = 65, 31{\%}; and (3) n = 57 (27{\%}) provided the best fit to the data. None of the participants in Cluster 1 were treated for alcohol-related events. All members of Cluster 2 were treated for alcohol-related events but only 23{\%} were diagnosed with an alcohol use disorder. Thirty-two members of Cluster 3 (56{\%}) were treated for alcohol-related events and Cluster 3 members were significantly higher than members of Clusters 1 and 2 on rates of: (1) alcohol use disorders (Wald statistic = 30.1, p < .001), (2) drug use disorders (Wald statistic = 42.3, p < .001), and 3) disruptive behavior disorders (Wald statistic = 19.3, p < .001). Conclusions: One group treated in the ED in this study is at low risk for alcohol-related injury. Conversely, one at risk-group may require brief interventions of low intensity while the other at-risk group displays high rates of comorbid psychiatric disorders and frequently engages in risk-taking behaviors, placing them at highest-risk for experiencing alcohol- related injuries. Reduction of alcohol-related injuries in young drinkers depends on differentiating high and low risk drinkers in the emergency department and providing, or referring them to appropriate treatment.",
keywords = "Adolescent, Alcohol-related injury, Emergency department, Latent class analysis, Psychiatric disorder",
author = "Kelly, {Thomas M.} and Tammy Chung and Donovan, {John E.} and Bukstein, {Oscar G.} and Cornelius, {Jack R.} and Salloum, {Ihsan M}",
year = "2006",
month = "3",
day = "1",
doi = "10.1300/J374v02n01_04",
language = "English",
volume = "2",
pages = "27--46",
journal = "Journal of Dual Diagnosis",
issn = "1550-4263",
publisher = "Routledge",
number = "1",

}

TY - JOUR

T1 - Comorbid psychiatric disorders and alcohol-related injury among adolescents and young adults treated in emergency departments

AU - Kelly, Thomas M.

AU - Chung, Tammy

AU - Donovan, John E.

AU - Bukstein, Oscar G.

AU - Cornelius, Jack R.

AU - Salloum, Ihsan M

PY - 2006/3/1

Y1 - 2006/3/1

N2 - Objectives: To investigate the prevalence and comorbidity of psychiatric disorders among 12-20 year-old patients treated in emergency departments. Methods: Two hundred-fifteen adolescents and young adults were recruited on weekends from two Level-1 trauma facilities located within a University-based medical center. Comprehensive psychiatric interviews were conducted with participants outside the emergency department. Latent class analysis was used to determine participant clusters based on DSM-IV psychiatric diagnoses and emergency treatment for an alcohol-related medical event as indicator variables, while controlling for covariates. Results: A three-cluster model: (1) n = 90, 42%; (2) n = 65, 31%; and (3) n = 57 (27%) provided the best fit to the data. None of the participants in Cluster 1 were treated for alcohol-related events. All members of Cluster 2 were treated for alcohol-related events but only 23% were diagnosed with an alcohol use disorder. Thirty-two members of Cluster 3 (56%) were treated for alcohol-related events and Cluster 3 members were significantly higher than members of Clusters 1 and 2 on rates of: (1) alcohol use disorders (Wald statistic = 30.1, p < .001), (2) drug use disorders (Wald statistic = 42.3, p < .001), and 3) disruptive behavior disorders (Wald statistic = 19.3, p < .001). Conclusions: One group treated in the ED in this study is at low risk for alcohol-related injury. Conversely, one at risk-group may require brief interventions of low intensity while the other at-risk group displays high rates of comorbid psychiatric disorders and frequently engages in risk-taking behaviors, placing them at highest-risk for experiencing alcohol- related injuries. Reduction of alcohol-related injuries in young drinkers depends on differentiating high and low risk drinkers in the emergency department and providing, or referring them to appropriate treatment.

AB - Objectives: To investigate the prevalence and comorbidity of psychiatric disorders among 12-20 year-old patients treated in emergency departments. Methods: Two hundred-fifteen adolescents and young adults were recruited on weekends from two Level-1 trauma facilities located within a University-based medical center. Comprehensive psychiatric interviews were conducted with participants outside the emergency department. Latent class analysis was used to determine participant clusters based on DSM-IV psychiatric diagnoses and emergency treatment for an alcohol-related medical event as indicator variables, while controlling for covariates. Results: A three-cluster model: (1) n = 90, 42%; (2) n = 65, 31%; and (3) n = 57 (27%) provided the best fit to the data. None of the participants in Cluster 1 were treated for alcohol-related events. All members of Cluster 2 were treated for alcohol-related events but only 23% were diagnosed with an alcohol use disorder. Thirty-two members of Cluster 3 (56%) were treated for alcohol-related events and Cluster 3 members were significantly higher than members of Clusters 1 and 2 on rates of: (1) alcohol use disorders (Wald statistic = 30.1, p < .001), (2) drug use disorders (Wald statistic = 42.3, p < .001), and 3) disruptive behavior disorders (Wald statistic = 19.3, p < .001). Conclusions: One group treated in the ED in this study is at low risk for alcohol-related injury. Conversely, one at risk-group may require brief interventions of low intensity while the other at-risk group displays high rates of comorbid psychiatric disorders and frequently engages in risk-taking behaviors, placing them at highest-risk for experiencing alcohol- related injuries. Reduction of alcohol-related injuries in young drinkers depends on differentiating high and low risk drinkers in the emergency department and providing, or referring them to appropriate treatment.

KW - Adolescent

KW - Alcohol-related injury

KW - Emergency department

KW - Latent class analysis

KW - Psychiatric disorder

UR - http://www.scopus.com/inward/record.url?scp=33746864846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33746864846&partnerID=8YFLogxK

U2 - 10.1300/J374v02n01_04

DO - 10.1300/J374v02n01_04

M3 - Article

AN - SCOPUS:33746864846

VL - 2

SP - 27

EP - 46

JO - Journal of Dual Diagnosis

JF - Journal of Dual Diagnosis

SN - 1550-4263

IS - 1

ER -