Prevalence and Recognition of Depressive Disorders in General Medical Inpatients

1988 ◽  
Vol 17 (4) ◽  
pp. 341-349 ◽  
Author(s):  
Michiel W. Hengeveld ◽  
Frans A. J. M. Ancion ◽  
Harry G. M. Rooijmans
Keyword(s):  
Depressive Disorder ◽  
Depressive Disorders ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Psychiatric Consultation ◽  
Consultant Psychiatrist ◽  
Symptoms Of Depression ◽  
Medical Inpatients ◽  
Medical Wards ◽  
Depressive Patients

The Beck Depression Inventory (BDI) was administered to 220 of 340 patients consecutively admitted to three general medical wards of a University Hospital, whose length of hospital stay was more than five days. At least mild symptoms of depression (BDI ≥ 13) were reported by 70/220 (32%) of the patients. Alternate BDI depressive patients underwent psychiatric consultation. The psychiatric consultant established a DSM-III depressive disorder in 10/33 (30%) of these patients. Only 3/10 (30%) of the DSM-III depressive patients had been referred to the consultant psychiatrist by their physician.

WED 027 Acute neurology in glasgow

2018 ◽  
Vol 89 (10) ◽  
pp. A4.4-A4
Author(s):  
Brennan M ◽  
Tyagi A ◽  
Leach JP
Keyword(s):  
Patient Care ◽  
University Hospital ◽  
Phone Calls ◽  
Neurological Illness ◽  
Medical Inpatients ◽  
Medical Wards

Provision of acute liaison in-patient neurology reduces demand on neurology out patient services, reduces unnecessary investigations and use of medical beds by patients waiting on in-patient neurology review and allows speedier access to necessary neurological services for those with a neurological illness.The pressure on acute neurology beds at QEUH Glasgow is immense and there is considerable delay in patients waiting for admission to the ward. An audit of the acute on call service in mid 2015 showed a 100% increase in the number of phone calls received by the on call registrar when compared to a similar audit in 2008. The number of requests for ward visiting to review medical inpatients at the Queen Elizabeth University hospital increased by more than 100% over the previous year.In June 2016 an Acute Neurology rota was introduced whereby a Consultant Neurologist supervised and delivered patient care for the acute neurology wards, referrals from medical wards and acute receiving, as well as twice a week acute neurology clinics. This has led to a significantly improved care for patients referred with neurological problems as perceived by trainees, consultants and referring medical physicians, as evident on a survey carried out in 2017.

Parental Characteristics in Relation to Depressive Disorders

1979 ◽  
Vol 134 (2) ◽  
pp. 138-147 ◽  
Author(s):  
Gordon Parker
Keyword(s):  
Depressive Disorder ◽  
Parental Care ◽  
Depressive Disorders ◽  
Control Group ◽  
Clinical Group ◽  
Valid Measure ◽  
Parental Overprotection ◽  
Parental Characteristics ◽  
Manic Depressive ◽  
Depressive Patients

SummaryUsing a reliable and valid measure of reported parental care and overprotection (the Parental Bonding Instrument) patients with two types of depressive disorder were compared with a control group, and the relationships to depressive experience examined in a non-clinical group as well. Bipolar manic-depressive patients scored like controls whereas neurotic depressives reported less parental care and greater maternal overprotection. Depressive experience in the non-clinical group was negatively associated with low parental care and weakly associated with parental overprotection.

scholarly journals Monetary valuation of a Quality-Adjusted Life Year (QALY) for depressive disorders among patients and non-patient respondents: A matched willingness to pay study

2021 ◽  
Vol 3 (4) ◽  
Author(s):  
Laura Ulbrich ◽  
Christoph Kröger
Keyword(s):  
Depressive Disorder ◽  
Willingness To Pay ◽  
Depressive Disorders ◽  
Treatment Options ◽  
Health Gain ◽  
Quality Adjusted Life Year ◽  
World Health ◽  
Health State ◽  
Symptoms Of Depression ◽  
Two Samples

Background As estimated by the World Health Organization, depressive disorders will be the leading contributor to the Global Burden of Disease by 2030. In light of this fact, we designed a study whose aim was to investigate whether the value placed on health-related quality of life (HRQoL) for a depressive disorder is higher in patients diagnosed with a major depressive disorder (MDD) compared to non-patients in a matched sample. Method We collected data on willingness to pay (WTP) for a total of four health-gain scenarios, which were presented to 18 outpatients diagnosed with a MDD versus 18 matched non-patient respondents with no symptoms of depression. Matching characteristics included age, income, level of education, and type of health insurance. Respondents were presented with different HRQoL scenarios in which they could choose to pay money to regain their initial health state through various treatment options (e.g., inpatient treatment, electroconvulsive therapy). To test whether the probability of stating a positive WTP differed significantly between the two samples, Fisher’s exact test was used. Differences regarding stated WTP between the samples were investigated using the Mann-Whitney U-test. Results For most of the health scenarios, the probability of stating a positive WTP did not differ between the two samples. However, patient respondents declared WTP values up to 7.4 times higher than those stated by matched non-patient respondents. Conclusion Although the perceived necessity to pay for mental-HRQoL gains did not differ between respondents with MDD and respondents with no symptoms of depression, patient respondents stated higher values.

Characteristics of elderly patients attended at a psychiatry emergency room

2011 ◽  
Vol 26 (S2) ◽  
pp. 834-834 ◽  
Author(s):  
L. Prats ◽  
N. Gual ◽  
P. Lusilla ◽  
A. Gual
Keyword(s):  
Depressive Disorder ◽  
Elderly Patients ◽  
Emergency Room ◽  
Depressive Disorders ◽  
Suicide Attempts ◽  
Psychiatric Symptoms ◽  
Psychiatric Inpatient ◽  
The Elderly ◽  
University Hospital ◽  
Common Diagnosis

IntroductionThere is no general agreement on the prevalence of mental disorders in the elderly, although it is estimated that 25%. of them present psychiatric symptoms. Geriatric psychiatry is one of the most rapidly advancing fields and requires a comprehensive approach.ObjectivesTo analyse the characteristics of patients older than 65 who are attended at the psychiatry emergency room.MethodsA descriptive study was conducted among all elderly pacients seen during May 2010 at the psychiatry emergency room at Vall d’Hebron University Hospital. Clinical variables (functional status, reason to show up, medical history, diagnosis), treatment and referral at discharge were analysed.Results36 patients (44.4% men, mean age 75.3 years) were identified. Charlson comorbidity index was 2.08. Suicide attempts were the most frequent reason for admission (27.8%), followed by psychomotor agitation (16.7%), anxiety disorders (13.9%), delirium (13.9%), depression (11.1%), and behaviour disorders (8.3%). Concerning psychiatric antecedents 58.3% had depressive disorder and 40% reported somatic symptoms during the month prior to their consultation.The most common diagnosis at discharge were anxiety-depressive disorders (52.7%) and delirium (16.7%). The most widely prescribed psychotropics were antipsychotics (19.4% haloperidol, 13.9% quetiapine) followed by benzodiazepines (13.9%). Referral at discharge was: 41.7% home, 13.9% midterm psychiatric units, 27.8% acute psychiatric inpatient unit and 16.7% Internal Medicine.ConclusionsTypically, elderly patients attended at the psychiatric emergency room are diagnosed of an anxiety-depressive disorder and often present with a suicidal attempt, but only 41.7% are admitted as psychiatric inpatients.

scholarly journals Do Inpatients Receive Risk-Based Prophylactic Treatment for Thrombotic Events?

2021 ◽  
Vol 27 ◽  
pp. 107602962199556
Author(s):  
Armin Nemani ◽  
Constantin von zur Mühlen ◽  
Friederike Steffen ◽  
Johannes Schulte ◽  
Christoph Bode ◽  
...  
Keyword(s):  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
University Hospital ◽  
Quantitative Risk Assessment ◽  
Bleeding Complications ◽  
Risk Category ◽  
Vte Prophylaxis ◽  
Risk Assessment Models ◽  
Hospital Patients ◽  
Medical Inpatients

Background: Current guidelines recommend risk-based use of prophylaxis for preventing medical inpatients from venous thromboembolism (VTE). Little is known about the current prescription practice, and even less whether differences between subspecialists like cardiologists, usually treating patients with thrombotic or thromboembolic diseases, and gastroenterologists, treating more patients with gastrointestinal bleeding complications, exist. Methods: We performed a retrospective chart review of patients on cardiology and gastroenterology wards of our university hospital. Patients with a clear indication for anticoagulation and contraindication against antithrombotic treatment were excluded. A total of 450 patients per specialty were included. Quantitative risk assessment models were used to determine the risk of a VTE (Padua Prediction Score (PPS), IMPROVE Score) and bleeding (IMPROVE-Bleeding and HAS-BLED Score). Results: The overall rate of VTE prophylaxis was high in both patient populations. Significant more low-risk cardiology compared to gastroenterology patients received drug-based prophylaxis. Furthermore, crucial discrepancies were found in the way individual patients would be classified based on PPS and IMPROVE Score. Finally, not the risk category but the length of hospital stay was best at predicting which patient received prophylaxis.

scholarly journals Validity of the CAGE questionnaire for screening alcohol-dependent inpatients on hospital wards

2005 ◽  
Vol 27 (1) ◽  
pp. 54-57 ◽  
Author(s):  
Maria Alicia Castells ◽  
Letícia Maria Furlanetto
Keyword(s):  
Alcohol Dependence ◽  
Structured Interview ◽  
University Hospital ◽  
Validity Indices ◽  
Medical Inpatients ◽  
Dsm Iv ◽  
Cage Questionnaire ◽  
Medical Wards ◽  
Hospital Wards ◽  
Transversal Study

OBJECTIVE: To verify the validity of the CAGE questionnaire in screening inpatients with alcohol dependence. METHODS: In a transversal study, 747 medical inpatients hospitalized on general medical wards in the Federal University of Santa Catarina University Hospital were evaluated. Sociodemographic and clinical data were collected and the following instruments were used: the CAGE questionnaire and the Mini International Neuropsychiatry Interview (MINI), the latter being a semi-structured interview used as the gold standard for diagnosing alcohol dependence (according to DSM-IV criteria). Validity indices (sensitivity and specificity) were assessed for the different possible CAGE cut-off points. The ROC curve was used to determine the best cut-off point. RESULTS: The sample was composed of 747 patients. Most were men (66%), white (85%) and married (61%). Mean age was 50 ± 17 years, and mean level of education was 6 ± 4 years. According to the MINI, 48 patients (6.6%) were diagnosed as having alcohol dependence. The CAGE questionnaire presented its highest sensitivity (93.8%) when the cut-off point of 0/1 (one or more "positive" responses indicating a positive test) was used. The specificity for this cut-off point was 85.5%. CONCLUSION: Using the 0/1 cut-off point, the CAGE questionnaire presented good sensitivity (93.8%) and specificity (85.5%) for use in general hospital ward patients. Since it is an easily applied, rapidly executed and inexpensive instrument, it could be useful in screening such patients for alcohol dependence.

Chronic benzodiazepine use in aged patients with depressive disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S542-S542
Author(s):  
N. Smaoui ◽  
L. Zouari ◽  
M. Maâlej-Bouali ◽  
N. Charfi ◽  
N. Zouari ◽  
...  
Keyword(s):  
Depressive Disorder ◽  
Depressive Disorders ◽  
Psychiatric Comorbidity ◽  
University Hospital ◽  
Socioeconomic Level ◽  
Aged Patients ◽  
Cross Sectional ◽  
Low Socioeconomic ◽  
Benzodiazepine Use ◽  
Competing Interest

ObjectiveTo identify predictive variables of chronic benzodiazepine use among elderly patients with depressive disorder.MethodsThis was a cross-sectional, descriptive and analytical study, including 41 patients suffering from depressive disorders, aged 65 years or more, treated with benzodiazepine (BZD) and followed-up in outpatient psychiatry unit at Hedi Chaker university hospital in Sfax in Tunisia. We used a standardized questionnaire including socio-demographic and clinical data. Chronic BZD use was defined as BZD availability at least 50% of the days between day 181 and day 365 following initiation.ResultsThe average age of patients was 69.29 ± 5.7 years. The sex ratio (M/F) was 0.5. The majority of them were married (78%), unemployed (82.9%) and living in urban area (61%). They had at most a primary degree (90.2%) and a low socioeconomic level (63.4%). The average time of BZD consumption was 4 years and 5 months.The prevalence of chronic BZD use in our sample was 56.1%. Duration of benzodiazepine use was greater than 1 year for all chronic BZD users. The mean dose of Benzodiazepine (Lorazepam) consumed was 3.87 ± 2.8 mg per day. Chronic BZD use was correlated with low socioeconomic level (86.3% vs 36.8%; P = 0.000), psychiatric comorbidity (72.7% vs 26.3%; P = 0.004) and recent hospitalization (59% vs 15.7%; P = 0.023).ConclusionThere is a high prevalence of chronic BZD use in our study. For the 65 years and older patients with depressive disorder, significant predictors of chronic BZD use were low socioeconomic level, psychiatric comorbidity and recent hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The impact of residual symptoms on relapse and quality of life among Thai depressive patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S326-S327
Author(s):  
T. Tantrarungroj ◽  
D. Nakawiro ◽  
T. Wongpakaran ◽  
N. Wongpakaran ◽  
P. Bookkamana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Regression Analysis ◽  
Depressive Disorder ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Residual Symptom ◽  
Residual Symptoms ◽  
Symptoms Of Depression ◽  
The Impact

IntroductionResidual symptoms of depressive disorder are major predictors of relapse of depression and lower quality of life. This study aims to investigate the prevalence of residual symptoms, relapse rates and quality of life among Thai patients with depressive disorders.MethodsHamilton Rating Scale for Depression (HAM-D) and EQ-5D were used to measure the symptoms of depression and quality of life, respectively. Prevalence of residual symptoms of depression was collected. Regression analysis was administered to predict relapse and patients’ quality of life at the 6 months post-baseline.ResultsTwo hundred and twenty-four depressive disorder patients were recruited. Most of patients (93.3%) had at least one residual symptom, and the most common residual symptom was anxiety symptoms (76.3%; 95% CI, 0.71 to 0.82). After 3 months post-baseline, 114 patients (50.9%) were in remission and within 6 months, 44 of them (38.6%) relapsed. Regression analysis showed that residual insomnia symptoms were significantly associated with these relapse cases (OR = 5.290, 95% CI, 1.42 to 19.76). Regarding quality of life, residual core mood and insomnia significantly predicted the EQ5D scores at 6 months post-baseline (B = −2.670, 95% CI, −181 to −.027, and B = −3.109, 95% CI, −172 to −.038, respectively).DiscussionResidual symptoms are common in patients receiving treatment for depressive disorder and were found to be associated with relapses and quality of life. Clinicians need to be aware of these residual symptoms when carrying out follow-up treatment in patients with depressive disorders, so that prompt action can be taken to mitigate the risk of relapse.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Identification of Psychiatric Morbidity by Internists and Subsequent Selection for Psychiatric Referral

1979 ◽  
Vol 9 (3) ◽  
pp. 317-327 ◽  
Author(s):  
Daniel S. P. Schubert ◽  
Laille Gabinet ◽  
William Friedson ◽  
Aaron Billowitz ◽  
Sheldon Miller
Keyword(s):  
Psychiatric Treatment ◽  
Psychiatric Morbidity ◽  
Holistic Approach ◽  
Psychiatric Consultation ◽  
Information Scale ◽  
Medical Inpatients ◽  
History Of ◽  
Selection For ◽  
Medical Wards ◽  
Subsequent Selection

Past literature raises the question as to the degree of identification of psychiatric morbidity among medical inpatients. A psychosocial information scale was used to rate charts of seventeen inpatients who later received a psychiatric consultation and seventeen who did not during the index admission. More psychosocial items were generally present in the charts with those patients receiving later psychiatric consultation overall and specifically in the areas of psychiatric chief complaint, history of behavior change and past psychiatric history. It was concluded that many patients with psychiatric morbidity on medical wards were not so identified and this was a prime reason for their non-referral, although several of the sub-groups of such patients could benefit from psychiatric treatment. Non-psychiatrists were urged to adopt a more holistic approach to medicine with emphasis on continuity of care to insure comprehensive diagnosis and management.

scholarly journals Depression among patients admitted to medical wards: comparison between a university hospital and regional hospital

Open Health ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 21-28
Author(s):  
Wipawee Hantrakul ◽  
Wittaya Wangsomboonsiri ◽  
Chutintorn Sriphrapradang
Keyword(s):  
Depressive Disorder ◽  
Regional Hospital ◽  
University Hospital ◽  
Health Coverage ◽  
Medical Patients ◽  
Cross Sectional ◽  
Factors Associated ◽  
Prevalence Of Depression ◽  
Baseline Characteristics ◽  
Medical Wards

AbstractObjective: We aimed to determine the prevalence of depression and to find factors associated with depression in admitted medical patients. The differences in the pattern of depression between a university hospital (UH) and a regional hospital (RH) were determined as well.Methods: This is a cross-sectional study. The Patient Health Questionnaire-9 (PHQ-9) was administered among hospitalized patients in medical wards. PHQ-9 could not differentiate between the type of depressive disorder that could be from medical conditions, adjustment disorder with depressed mood, major depressive disorder, or dysthymia.Results: A total of 343 patients (191 in UH, 152 in RH group) with age of 52.1 ± 16.9 years were included. Timing of interview was 4.3 ± 1.4 days after admission. The prevalence of depression (PHQ-9 score ≥ 9) was 12% (7.3% in UH vs 17.8% in RH, p < 0.005). According to PHQ-9 scoring, the prevalence of moderate-to-severe depression was 3.8%. Mean PHQ-9 score in RH was significantly higher than in UH (p < 0.001). Multiple baseline characteristics were analyzed by logistic regression and found no factors associated with depression. There was no difference in baseline characteristics of UH patients with depression compared to RH, except for universal health coverage plan.Conclusions: The prevalence of depression was 1 in 10 patients and was found to be more frequent and severe in RH than UH. All patients were at equal risk to develop depression during admission.

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