Background: Psychological distress in medical patients admitted to the emergency department (ED) is not well\nstudied. Our aim was to investigate the extent of psychological distress in a broad and unselected medical patient\nsample 30 days after ED admission and its association with socio-demographic and clinical variables.\nMethod: We used data from a prospective observational cohort study including 1575 consecutive adult medical\npatients presenting to the ED with acute somatic conditions. Outcome variables were patientââ?¬â?¢s psychological\ndistress measured by the 4-item Patient Health Questionnaire (PHQââ?¬â??4) and self-rated health assessed 30 days after\nED admission using telephone interviews. Risk factors included socio-demographic variables (e.g. gender, marital\nstatus), clinical presentation (e.g. illness severity, main initial diagnosis) and course of illness (e.g. rehospitalisation,\nlength of hospital stay).\nResults: A total of 38 % of patients had evidence for psychological distress 30 days after ED admission. Multivariate\nanalysis found female gender (adjusted odds ratio [aOR] 1.35, 95 % confidence interval [CI] 1.02 to 1.78), comorbid\npsychiatric disorder (aOR 1.63, 95 % CI 1.08 to 2.62), discharge to a post-acute care institution (aOR 1.47, 95 % CI 1.\n03 to 2.09), unplanned rehospitalisation (aOR 2.38, 95 % CI 1.47 to 3.86), and unplanned visit at general practitioner\n(aOR 4.75, 95 % CI 2.57 to 8.80) to be associated with distress at day 30 following ED admission.\nConclusions: One month after ED admission a significant number of patients still show a moderate amount of\npsychophysical distress. Strongest related variables were course of illness, in particular unplanned general practitioner\nvisits. Future interventional studies should assess possibilities to reduce distress in patients at increased risk.\nTrial registration: NCT01768494, January 9, 2013 (registration date), February 25, 2013 (enrolment of first participant
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