Objective: To determine the extent to which depressive and alcoholic symptoms are related to aggressiveness in male emergency department (ED) patients.
Methods: A cross-sectional survey design was conducted in a Midwest urban ED. A convenience sample of 302 noncritical male patients completed the survey. Self-reported aggressiveness, anger problems, Zung depressive symptoms, CAGE alcoholic dependence, and demographics were collected. A conceptual causal model was tested with structural equation (SEQ) modeling. Regression analyses examined the extent to which the Zung scale, CAGE inventory, and demographics explained aggressiveness.
Results: The SEQ modeling found that both depressive and alcoholic symptoms linked significantly to aggressiveness. Depressive symptoms linked three times more strongly than alcoholic symptoms to aggressiveness. Model fit statistics suggested that depressive and alcoholic symptoms are plausible causal factors for male aggressiveness. Regression analyses revealed that four items from the Zung scale (irritable, can't sleep, "better off dead," indecisive) and two items from the CAGE inventory (annoyed when criticized about drinking, need to cut down) explained aggressiveness.
Conclusions: In this urban ED population, depressive symptoms linked to aggressiveness three times more strongly than alcoholic symptoms. An abbreviated screening tool that could be used in EDs incorporating Zung and CAGE items may identify males who would benefit from further evaluation for depression, alcoholism, and aggressive behavior.