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. © 2005 by The Haworth Press, Inc. All rights reserved.