Why was the syndrome created?
This is a Syndrome Definition (SD) Subcommittee community-developed syndrome definition for mental health conditions likely to increase in emergency department frequency during and after natural or human-caused disaster events. This syndrome definition attempts to leverage only mental health conditions and presentations that showed increases in visit frequency after select disasters in the United States. There are no disaster-related terms inherent to this query, rather the SD decided to leave it to the user to leverage event-specific terms.
SD members reviewed mental health presentations and selected possible post-disaster ED presentations captured in syndromic data across the USA. ICD10 codes were reviewed for conditions related to Stress, Anxiety, Phobic Anxiety, Acute PTSD, and Panic. PTSD and Phobic Anxiety were not included after initial review. Syndromes were developed for Stress, Anxiety, and Panic; all starter syndromes were based on relevant ICD10 codes. These initial syndromes were reviewed for relevant Chief Complaint terms contained in these ICD10-positive visits. Other Chief Complaint terms were identified from existing syndromes shared by the community and CDC. Volunteers with historical syndromic surveillance data during a disaster were asked to review trendlines relative to the disaster along with a line-level review to determine highly relevant and false positive terms. The syndrome was tested on data during and after a hurricane, flood, earthquake and a mass shooting event.
The SDC designed the query to pull ICD10 codes and key Chief Complaint terms from the CCDD field. The ICD10 code F41.9, “Anxiety disorder, unspecified” was not included due to the large volume of visits with this diagnosis code.
The query has been added to NSSP BioSense Platform ESSENCE as a CC and DD Category called Disaster-related Mental Health v1.
Data sources the syndrome was used on (e.g., Emergency room, EMS, Air Quality, etc.)
Emergency room
Fields used to query the data (e.g., Chief Complaint, Discharge Diagnosis, Triage Notes, etc.)
Chief Complaint, Discharge Diagnosis
^[;/ ]F41.[0138]^,or,^[;/ ]F41[0138]^,or,^[;/ ]F43.[089]^,or,^[;/ ]F43[089]^,or,^[;/ ]r45.7^,or,^[;/ ]r457^,or,^overwhelm^,or,(,^[/ ;.]stress^,or,stress^,),andnot,(,^stress test^,or,^fetal stress^,or,^stress fracture^,or,^stressfracture^,),or,^anxiety^,or,^anxi[ou][ou]s^,or,^aniety^,or,^axiety^,or,^anexiy^,or,^aniexty^,or,^ansiety^,or,^anxety^,or,^anxity^,or,^nerv[ou][ou]s^,or,^panic^,or,^mental health^,or,^MH eval^,or,^MHE^,or,^situational crisis^,or,^crisis eval^,or,(,^Psych^,and,(,^eval^,or,^consult^,),)