Depression in internal medicine inpatients at the time of hospital discharge and referral to primary care

IF 2.5 4区 医学 Q2 PSYCHIATRY
F. Barcones , A. Bulbena , A. Campayo , R. Campos , M. Lozano , A. Cebollada , J. de Pablo , J. Farré , E. García-Camba , J. García-Campayo , M. Girón , E. Lobo , G. Marcos , C. Mingote , L. Salvador-Carulla , J. Santabárbara , P. Saz , A. Lobo
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Abstract

Background and objectives

This is the first multi-center study intended to document the prevalence, characteristics, and associations of depression in Medicine patients at the time of hospital discharge and their referral to Primary Care (PC).

Methods

Adult patients randomly selected among consecutive admissions to Medicine wards in 8 hospitals in Spain, covering health districts, were examined in a two-phase 'case-finding' procedure. Standardized, Spanish versions of instruments were used, including the Standardized Polyvalent Psychiatric Interview (SPPI) and Cumulative Illness Rating Scale (CIRS). Cases of depression were diagnosed according to ICD-10 general hospital research criteria.

Results

Three hundred and twelve patients with treatable depression and 777 non-depressed controls were identified. In a conservative estimate, the global prevalence of major depression was 7.1%, dysthymia 4.2% and adjustment depression 7.1%, and 51.9% of cases were of moderate/ severe intensity. Depression was more frequent in women, the differences being significant in all categories of depression. The prevalence of depression was lower in individuals aged 85 or more years, the differences being significant in cases of both dysthymia and adjustment depression. A clear pattern of decreasing prevalence with age was observed in women. The depressed had as an average five medical systems affected, and higher CIRS scores compared with the controls, the differences being significant in cases of both major depression and dysthymia.

Conclusions

This is the first report showing a considerable prevalence of treatable cases of depression in Medicine patients at the time of hospital discharge and referral to PC. Depression is associated with the severity of the medical condition, and differences observed by age and sex have clinical implications. Paper read at the 3rd Annual Meeting of the European Association of Psychosomatic Medicine, Nuremberg 2015.

内科住院患者在出院和转介到初级保健时的抑郁症
背景和目的这是第一项多中心研究,旨在记录出院和转诊到初级保健(PC)时内科患者抑郁的患病率、特征和关联,在两个阶段的“病例发现”程序中进行了检查。使用了标准化的西班牙语版工具,包括标准化多价精神病访谈(SPPI)和累积疾病评定量表(CIRS)。根据ICD-10综合医院研究标准诊断抑郁症病例。结果共发现312例可治疗的抑郁症患者和777例非抑郁症对照者。保守估计,全球重度抑郁症的患病率为7.1%,心境恶劣症为4.2%,调节性抑郁症为7.1%。51.9%的病例为中度/重度。抑郁症在女性中更为常见,在所有类型的抑郁症中差异都很显著。85岁或85岁以上人群的抑郁症患病率较低,在心境恶劣和调节性抑郁症患者中差异显著。在妇女中观察到明显的患病率随年龄的增长而下降的模式。抑郁症患者平均有五个医疗系统受到影响,与对照组相比,CIRS评分更高,在严重抑郁症和心境恶劣的情况下差异显著。结论本报告首次显示,在出院和转诊到PC时,内科患者中可治疗的抑郁症病例相当普遍。抑郁症与疾病的严重程度有关,年龄和性别的差异具有临床意义。2015年纽伦堡欧洲心身医学协会第三届年会上宣读的论文。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
40
审稿时长
43 days
期刊介绍: The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.
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