背景:常客(FPs)是一组经常到医院急诊科(ED)进行紧急护理的个人。该组中的许多人都有精神健康状况的主要诊断。这组个体倾向于不成比例地使用ED资源,并显着影响整体医疗保健结果。以前的评论没有检查过患有精神健康状况的FP的概况。
目的:本研究旨在通过对现有文献进行全面的系统回顾,确定频繁出现有心理健康初步诊断的ED患者的关键社会人口统计学和临床特征。
方法:使用PRISMA指南。PubMed,PsycINFO,Scopus和WebofScience(WOS)于2023年5月进行了搜索。同时对所收录文章的参考列表进行了手动搜索。Covidence被用来进行提取和筛选,由两位作者独立完成。定义了纳入和排除标准。
结果:筛选了3341篇非重复文章的摘要,有40篇全文被评估为合格性。纳入了2004年至2022年在6个国家/地区进行的20项研究,患者总数为25,688例(52%为男性,48%为女性,平均年龄40.7岁)。27%的人失业,20%已婚,41%无家可归17%拥有高等教育或以上学历。44%有药物滥用或酒精依赖史。前3名诊断为焦虑症(44%),抑郁症(39%)精神分裂症谱和其他精神病(33%)。
结论:平均而言,FP是中年人,在两种性别中同样普遍。目前的数据缺乏性别多样化群体的代表性。它们与高失业率密切相关,无家可归,低于平均教育水平,和单身。焦虑症,抑郁症,和精神分裂症谱系障碍是与该群体相关的最常见的临床诊断。
BACKGROUND: Frequent presenters (FPs) are a group of individuals who visit the hospital emergency department (ED) frequently for urgent care. Many among the group present with the main diagnosis of mental health conditions. This group of individual tend to use ED resources disproportionally and significantly affects overall healthcare outcomes. No previous reviews have examined the profiles of FPs with mental health conditions.
OBJECTIVE: This study aims to identify the key socio-demographic and clinical characteristics of patients who frequently present to ED with a mental health primary diagnosis by performing a comprehensive systematic
review of the existing literature.
METHODS: PRISMA guideline was used. PubMed, PsycINFO, Scopus and Web of Science (WOS) were searched in May 2023. A manual search on the reference list of included articles was conducted at the same time. Covidence was used to perform extraction and screening, which were completed independently by two authors. Inclusion and exclusion criteria were defined.
RESULTS: The abstracts of 3341 non-duplicate articles were screened, with 40 full texts assessed for eligibility. 20 studies were included from 2004 to 2022 conducted in 6 countries with a total patient number of 25,688 (52% male, 48% female, mean age 40.7 years old). 27% were unemployed, 20% married, 41% homeless, and 17% had tertiary or above education. 44% had a history of substance abuse or alcohol dependence. The top 3 diagnoses are found to be anxiety disorders (44%), depressive disorders (39%) schizophrenia spectrum and other psychotic disorders (33%).
CONCLUSIONS: On average, FPs are middle-aged and equally prevalent in both genders. Current data lacks representation for gender-diverse groups. They are significantly associated with high rates of unemployment, homelessness, lower than average education level, and being single. Anxiety disorder, depressive disorder, and schizophrenia spectrum disorders are the most common clinical diagnoses associated with the group.