O’Reilly, Lauren M.Dalal, Azhar I.Maag, SerenaPerry, Matthew T.Card, AlexBohrer, Max B.Hamersly, JacksonNader, Setarah MohammadPeterson, KelliBeiser, David G.Gibbons, Robert D.D’Onofrio, Brian M.Musey, Paul I.2023-08-242023-08-242022-09-22O'Reilly LM, Dalal AI, Maag S, et al. Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints. J Am Coll Emerg Physicians Open. 2022;3(5):e12804. Published 2022 Sep 22. doi:10.1002/emp2.12804https://hdl.handle.net/1805/35112Objectives: To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT-MH), (2) the correlation among CAT-MH scores and self- and clinician-reported assessments, and (3) the association between CAT-MH scores and ED utilization in the year prior and 30 days after enrollment. Methods: This was a single-center observational study of adult patients presenting to the ED for somatic complaints (97%) from May 2019 to March 2020. The main outcomes were computer-adaptive-assessed domains of suicidality, depression, anxiety, post-traumatic stress disorder (PTSD), and substance use. We conducted Pearson correlations and logistic regression for objectives 2 and 3, respectively. Results: From a sample of 794 patients, the proportion of those at moderate/severe risk was: 24.1% (suicidality), 8.3% (depression), 16.5% (anxiety), 12.3% (PTSD), and 20.4% (substance use). CAT-MH domains were highly correlated with self-report assessments (r = 0.49-0.79). Individuals who had 2 or more ED visits in the prior year had 62% increased odds of being in the intermediate-high suicide risk category (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.07-2.44) compared to those with zero prior ED visits. Individuals who scored in the intermediate-high-suicide risk group had 63% greater odds of an ED visit within 30 days after enrollment compared to those who scored as low risk (OR, 1.63; 95% CI, 1.09, 2.44). Conclusion: The CAT-MH documented that a considerable proportion of ED patients presenting for somatic problems had mental health conditions, even if mild. Mental health problems were also associated with ED utilization.en-USAttribution-NonCommercial-NoDerivatives 4.0 InternationalAnxietyDepressionMental healthScreeningSuicideUtilizationArticle