DISEASES AND PROBLEMS DISTINGUISHED BY WHO AND FAO / RESEARCH PAPER
Exploring the complex interplay between acute stress, anxiety, and depression: a cross-sectional analysis among emergency department patients
1
Department of Nursing, Graduate School, Istanbul Okan University, Istanbul, Türkiye
2
School of Nursing, Maltepe University, Istanbul, Türkiye
These authors had equal contribution to this work
Submission date: 2024-11-23
Final revision date: 2025-03-30
Acceptance date: 2025-03-31
Online publication date: 2025-04-08
Corresponding author
Ece Alagöz
School of Nursing, Maltepe University, Marmara Eğitim Köyü, Büyükbakkalköy Mah. Büyükbakkalköy Yolu Sk. Nr:39, 34857 Maltepe/Istanbul, Türkiye,
School of Nursing, Maltepe University, Marmara Eğitim Köyü, Büyükbakkalköy Mah. Büyükbakkalköy Yolu Sk. Nr:39, 34857 Maltepe/Istanbul, Türkiye,
Health Prob Civil. 2026;20(2):142-151
KEYWORDS
TOPICS
ABSTRACT
Background:
This study evaluated acute stress symptom severity, anxiety, and depression levels in emergency department patients and examined their interrelationships.
Material and methods:
A cross-sectional design was employed. The Acute Stress Symptom Severity Scale (ASSSS) assessed stress severity, while the Hospital Anxiety and Depression Scale (HADS) evaluated anxiety and depression. Descriptive statistics and correlation analyses were conducted.
Results:
The mean ASSSS score was 8.77±3.43, indicating moderate acute stress, with scores ranging from 2.0 to 20.0 and a median of 9.0. The mean HADS-Anxiety score was 9.14±3.33, with a median of 10.0, reflecting moderate anxiety (range: 2.0-19.0). The mean HADS-Depression score was 11.07±4.41, with a median of 10.0, indicating moderate depression with more variability (range: 1.0-21.0). Correlation analyses showed a weak positive relationship between the ASSSS and HADS-Anxiety scores (r=0.290, p<0.001), suggesting higher acute stress is linked to increased anxiety. A weak negative correlation between the ASSSS and HADS-Depression scores (r=-0.364, p<0.001) indicated higher stress is associated with lower depression levels.
Conclusions:
Acute stress is moderately prevalent in emergency patients and positively correlates with anxiety while negatively correlating with depression. Integrated approaches are essential for managing these interconnected conditions in emergency care.
This study evaluated acute stress symptom severity, anxiety, and depression levels in emergency department patients and examined their interrelationships.
Material and methods:
A cross-sectional design was employed. The Acute Stress Symptom Severity Scale (ASSSS) assessed stress severity, while the Hospital Anxiety and Depression Scale (HADS) evaluated anxiety and depression. Descriptive statistics and correlation analyses were conducted.
Results:
The mean ASSSS score was 8.77±3.43, indicating moderate acute stress, with scores ranging from 2.0 to 20.0 and a median of 9.0. The mean HADS-Anxiety score was 9.14±3.33, with a median of 10.0, reflecting moderate anxiety (range: 2.0-19.0). The mean HADS-Depression score was 11.07±4.41, with a median of 10.0, indicating moderate depression with more variability (range: 1.0-21.0). Correlation analyses showed a weak positive relationship between the ASSSS and HADS-Anxiety scores (r=0.290, p<0.001), suggesting higher acute stress is linked to increased anxiety. A weak negative correlation between the ASSSS and HADS-Depression scores (r=-0.364, p<0.001) indicated higher stress is associated with lower depression levels.
Conclusions:
Acute stress is moderately prevalent in emergency patients and positively correlates with anxiety while negatively correlating with depression. Integrated approaches are essential for managing these interconnected conditions in emergency care.
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