Major depression and recent physical or sexual abuse increase readmissions among high-utilising primary care patients

Objective: To investigate whether current major depression and past physical/sexual victimisation is associated with recurrent general hospital admissions. Method: Ninety-six inner-city primary care patients with a history of high medical service utilisation completed the PRIME-MD and the Abuse Assessment Screen; medical records were reviewed to assess reasons for re-hospitalisations. We compared hospitalisation rates over the preceding 12 months between those subjects with and without major depression and those with and without histories of abuse. Results: Compared to non-abused subjects, patients with past-year abuse showed significantly increased past-year hospitalisations (3.2 versus 1.8, P = 0.007). Re-admissions were related to chronic disease management and were not because of acute physical effects of trauma. Analysis of variance revealed that major depressive disorder and past-year abuse history interacted to increase an association with re-admissions. Conclusions: Past-year abuse was independently associated with increased hospital admissions. Psychological effects of recent abuse combined with depression may particularly increase rates of medical/surgical hospitalisations.