Combination of Physical and Mental Illness Increases ER Visits

The combination of mental disorders and physical illness is associated with higher frequency of emergency department visits than observed in individuals with multiple mental disorders or physical illnesses, according to the results of a recent study.

Although multimorbidity and mental disorders have been shown to be associated with frequent emergency department visits, the interaction between the two is less well understood.

To explore this further, researchers conducted a population-based cohort study of 4,316,832 from the Quebec Integrated Chronic Disease Surveillance System from 2012 to 2016.

Overall, they found that in individuals with mental disorders, each additional physical illness was associated with a greater increase in the absolute risk of frequent emergency department visits.

For patients with between 0 and 4 or more physical illnesses, the frequency of emergency department visits increased more in those with serious mental disorders (16.2%) than in those with common mental disorders (15.2%) or no mental disorders (11.4%). Serious mental disorders included schizophrenia and schizoaffective disorders, bipolar and manic disorders, and other psychotic disorders.

“Our study shows the potential synergy between physical multimorbidity and mental disorders with respect to frequent visits to the emergency department. More research is needed to understand at-risk populations and test suitable interventions to promote high-quality care for mental illness that have the potential to reduce avoidable visits to the emergency department,” they concluded.

—Michael Potts

Reference:

Gaulin M, Simard M, Candas B, et al. Combined impacts of multimorbidity and mental disorders on frequent emergency department visits: a retrospective cohort study in Quebec, Canada [published online July 2, 2019. CMAJ. DOI: https://doi.org/10.1503/cmaj.181712