Sex and age differences in ED patients with mental and behavioral disorders due to psychoactive substance use

ObjectivesThe objectives of this study are to describe an emergency department (ED) adult population with the chief complaint of mental and behavioral disorders due to psychoactive substance use and to investigate sex- and age-related differences.MethodsWe analyzed data (2009-2011) from the Regional Observatory of Emergency Medicine ORU-MiP (700 000 patients per year) for all patients with a primary diagnosis of mental and behavioral disorders due to psychoactive substance use. Day data were weighted by the number of days in the year and expressed for 100 000 inhabitants of the area. Pearson χ2 test and Fisher tests were used. The Brown-Mood test was used to compare medians.ResultsOf the 1 411 597 ED visits analyzed, 20 838 consults (1.3%) were for primary diagnosis of mental and behavioral disorders due to psychoactive substance use. The median age (interquartile range) was 41 (28-51) years; 69.5% were men. More women consulted the ED for sedative or hypnotic use (4.9% vs 1.5%, P < 10− 4) than men, and more men consulted for alcohol consumption (93.5% vs 90%, P < 10− 4) and cannabinoids (1.4% vs 1.0%, P < 10− 3) than women. Young consumer visits dramatically increased during weekends (average of 88 visits a day per 100 000 inhabitants vs 34 on Mondays to Thursdays). Another difference was found between young adults and middle-aged adults, with a peak in visits at 2 am and 9 pm respectively.ConclusionsMental and behavioral disorders due to psychoactive substance use account for 1.3% of ED visits. Older people should be screened for chronic alcohol consumption. Our findings underscore the opportunity provided by the ED for screening and brief intervention in drug- and alcohol-related problems.