Factors associated with cognitive impairment for people with mental health disorders: screening from general hospitals and an emergency care unit in Brazil

Abstract Background Emergency services and mental health units in general hospitals play a central role in the initial care and treatment of individuals with mental disorders. Early diagnosis and treatment of mental disorders and substance abuse can reduce cognitive deficits in this population. This...

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Main Authors: Alice Hirdes, Johanna de Almeida Mello, Wagner de Lara Machado, Elton Luiz Ferlin, John P. Hirdes
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-06805-4
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author Alice Hirdes
Johanna de Almeida Mello
Wagner de Lara Machado
Elton Luiz Ferlin
John P. Hirdes
author_facet Alice Hirdes
Johanna de Almeida Mello
Wagner de Lara Machado
Elton Luiz Ferlin
John P. Hirdes
author_sort Alice Hirdes
collection DOAJ
description Abstract Background Emergency services and mental health units in general hospitals play a central role in the initial care and treatment of individuals with mental disorders. Early diagnosis and treatment of mental disorders and substance abuse can reduce cognitive deficits in this population. This study aims to investigate the factors associated with cognitive impairment for people with mental health disorders and addictions. Methods This is a cross-sectional study performed in two general hospitals and an Emergency Care Unit (UPA) in cities in the metropolitan region of Porto Alegre, Rio Grande do Sul, Brazil. The interRAI Emergency Screener for Psychiatry (ESP) was used to describe the study population and to build an adjusted logistic model for the risk factors of cognitive impairment. Results A total of 324 persons participated in the study (mean age: 41.8 ± 14.27, 50,2% female). The profile of people admitted to the different locations varied in several aspects according to the interRAI scales. The UPA received patients with acute conditions and higher scores on the Aggressive Behavior Scale, Mania Scale, the Scale of Harm to Others, and the Scale of Positive Symptoms. Patients at the university hospital had the highest rates of social withdrawal and a higher proportion of individuals with no insight into their mental health problems. The factors with the highest odds ratio were a diagnosis of schizophrenia (O.R.: 3.07; C.I. 1.13; 8.32), followed by self-care inability (O.R.: 2.87, 1.43; 5.77) and the aggressive behavior scale (2.85, 1.10; 7.44). A history of discharges, the Mania Scale and sleeping problems were also significantly associated with cognitive impairment. People being admitted to the UPA had lower odds of having cognitive impairment (O.R.: 0.18; 0.07; 0.45). Conclusion People diagnosed with schizophrenia were at very high risk of cognitive impairment. A prior history of discharges, inability to self-care, aggressive behavior, symptoms of mania and sleeping disturbances were also identified as risk factors. The interRAI EPS instrument showed to be useful to identify people with mental health disorders and substance abuse who were at risk of cognitive impairment. By early detecting these clients, professionals can refer them to adequate treatment, before symptoms increase.
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spelling doaj-art-eef68c541a2047cf84e344d219e03bd22025-08-20T02:28:42ZengBMCBMC Psychiatry1471-244X2025-04-0125111010.1186/s12888-025-06805-4Factors associated with cognitive impairment for people with mental health disorders: screening from general hospitals and an emergency care unit in BrazilAlice Hirdes0Johanna de Almeida Mello1Wagner de Lara Machado2Elton Luiz Ferlin3John P. Hirdes4Graduate Program in Nursing, Federal University of Rio GrandeLUCAS – Centre for Care Consultancy, KU LeuvenGraduate Program in Psychology, Pontifical Catholic University of Rio Grande do SulBiostatistic and Data Analysis Unit, Hospital de Clínicas de Porto AlegreSchool of Public Health Sciences, University of WaterlooAbstract Background Emergency services and mental health units in general hospitals play a central role in the initial care and treatment of individuals with mental disorders. Early diagnosis and treatment of mental disorders and substance abuse can reduce cognitive deficits in this population. This study aims to investigate the factors associated with cognitive impairment for people with mental health disorders and addictions. Methods This is a cross-sectional study performed in two general hospitals and an Emergency Care Unit (UPA) in cities in the metropolitan region of Porto Alegre, Rio Grande do Sul, Brazil. The interRAI Emergency Screener for Psychiatry (ESP) was used to describe the study population and to build an adjusted logistic model for the risk factors of cognitive impairment. Results A total of 324 persons participated in the study (mean age: 41.8 ± 14.27, 50,2% female). The profile of people admitted to the different locations varied in several aspects according to the interRAI scales. The UPA received patients with acute conditions and higher scores on the Aggressive Behavior Scale, Mania Scale, the Scale of Harm to Others, and the Scale of Positive Symptoms. Patients at the university hospital had the highest rates of social withdrawal and a higher proportion of individuals with no insight into their mental health problems. The factors with the highest odds ratio were a diagnosis of schizophrenia (O.R.: 3.07; C.I. 1.13; 8.32), followed by self-care inability (O.R.: 2.87, 1.43; 5.77) and the aggressive behavior scale (2.85, 1.10; 7.44). A history of discharges, the Mania Scale and sleeping problems were also significantly associated with cognitive impairment. People being admitted to the UPA had lower odds of having cognitive impairment (O.R.: 0.18; 0.07; 0.45). Conclusion People diagnosed with schizophrenia were at very high risk of cognitive impairment. A prior history of discharges, inability to self-care, aggressive behavior, symptoms of mania and sleeping disturbances were also identified as risk factors. The interRAI EPS instrument showed to be useful to identify people with mental health disorders and substance abuse who were at risk of cognitive impairment. By early detecting these clients, professionals can refer them to adequate treatment, before symptoms increase.https://doi.org/10.1186/s12888-025-06805-4Cognitive functioningMental disordersAddictionsScreeningGeneral hospitalEmergency psychiatric services
spellingShingle Alice Hirdes
Johanna de Almeida Mello
Wagner de Lara Machado
Elton Luiz Ferlin
John P. Hirdes
Factors associated with cognitive impairment for people with mental health disorders: screening from general hospitals and an emergency care unit in Brazil
BMC Psychiatry
Cognitive functioning
Mental disorders
Addictions
Screening
General hospital
Emergency psychiatric services
title Factors associated with cognitive impairment for people with mental health disorders: screening from general hospitals and an emergency care unit in Brazil
title_full Factors associated with cognitive impairment for people with mental health disorders: screening from general hospitals and an emergency care unit in Brazil
title_fullStr Factors associated with cognitive impairment for people with mental health disorders: screening from general hospitals and an emergency care unit in Brazil
title_full_unstemmed Factors associated with cognitive impairment for people with mental health disorders: screening from general hospitals and an emergency care unit in Brazil
title_short Factors associated with cognitive impairment for people with mental health disorders: screening from general hospitals and an emergency care unit in Brazil
title_sort factors associated with cognitive impairment for people with mental health disorders screening from general hospitals and an emergency care unit in brazil
topic Cognitive functioning
Mental disorders
Addictions
Screening
General hospital
Emergency psychiatric services
url https://doi.org/10.1186/s12888-025-06805-4
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