A Prospective Study of Depression Among Adult Patients in an Urban Emergency Department

UMMS Affiliation

Department of Emergency Medicine

Publication Date


Document Type



Depression; Emergency Service, Hospital


Emergency Medicine


Objective: To determine prevalence and predictors of depression among emergency department (ED) patients.

Method: For 1 week in November 2003, consecutive adult patients presenting to an urban ED from 8:00 a.m. to midnight were screened for a DSM-IV major depressive episode using the Harvard Department of Psychiatry National Depression Screening Day Scale. Patients who were severely ill or who had altered mental status were excluded. Demographic factors, psychiatric history, and brief medical history also were assessed.

Results: Of 182 patients enrolled, 57 (32%, 95% CI = 25 to 39) screened positive for depression, which was much greater than general community estimates (6.6%, p < .0001). Depression was more likely (p < .001) in patients with a psychiatric history (61% vs. 22%), substance abuse history (65% vs. 30%), or a suicide attempt (67% vs. 30%). Eleven percent (95% CI = 7 to 17) of subjects endorsed suicidal ideation at least "some of the time."Limitations: This sample underrepresented severely ill, acutely distressed, or cognitively disabled patients. The most likely effect of these exclusion criteria was to yield an underestimate of depression. Also, the ED was located in a northeastern, urban city, which may not represent the rest of the country. Finally, we used a screening instrument without established operating characteristics within the ED setting.

Conclusion: Although findings suggest that depression is common, it is often ignored in the ED setting. Recent efforts to increase awareness of depression in outpatient medical settings may be warranted in EDs as well.


Prim Care Companion J Clin Psychiatry. 2006;8(2):66-70.

Journal/Book/Conference Title

Primary care companion to the Journal of clinical psychiatry


At the time of publication, Edwin Boudreaux was not yet affiliated with the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID