Abstract
Background: This study analyzed the prevalence of mental disorders among appendectomy patients, comparing differences between patients with and without mental disorders to explore the potential for a psychiatric cost-offset effect. Methods: Records of 209,822 appendectomy patients age 18 and older were abstracted from 1994-2009 Florida hospital discharge data. Chisquare tests, t-tests, and logistic regression were performed. Results: Of the study population, 5.1% were diagnosed with a mental disorder. Odds for psychotic, schizophrenic, affective, neurotic, and depressive disorders were significantly greater above age 28. Females had significantly greater odds for affective, neurotic, and depressive disorders. Negative appendectomy was significantly positively associated with neurotic and other mental disorders. Irritable bowel syndrome and ill-defined rightlower abdominal pain were each independently significantly associated with neurotic, depressive, and other mental disorders. Psychotic and schizophrenic disorders were significantly associated with lengths of stay above two days, and other mental disorders above three days. Affective, neurotic, depressive, and other mental disorders were significantly associated with hospital charges totaling $18,941 or more, psychotic disorders totaling $26,860 or more, and schizophrenic disorders totaling $39,106 or more. Conclusions: Longer stays and higher charges incurred by appendectomy patients diagnosed with mental disorders raise the prospect of a potential psychiatric cost-offset effect. Improved diagnosis of mental disorders and irritable bowel syndrome in patients presenting with functional abdominal pain suspected to be psychogenic in origin is indicated, as are referrals to appropriate mental and/or physical health treatment professionals.
Published Version
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