Articles

Recognition of Depression and Anxiety by Non-Psychiatric Residents in a General Hospital

Abstract

Objective: The objective of this study was to determine the ability of non-psychiatric (medical and surgical residents) residents on inpatient units to recognize patients with clinically significant depression and anxiety among a cohort admitted to the Dr. Shariati Hospital in Tehran.
Method:
Patients within 72 hours of admission underwent screening with the Hospital Anxiety and Depression Scale(HADS). Simultanously the residents caring for the patients was assessed whether they believed that patients had significant depression or anxiety. They should also rate the degree of depression and anxiety of their patients in a 5 point Likert scale.
Results:
Assessments were completed for 401 patients. According to HADS score 136(34.25%) patients had probable depressive disorders and 157(39.75%) patients had probable anxiety disorders. The residents only asked from 26(6.4%) and 32(8.2%) patients about depression and anxiety respectively. They identified only 10.2% of patients with probable depressive disorder (HADS-D score>7) and10.8% of patients with probable anxiety disorder(HADS-A score>7). There was no significant correlation of residents' assessment of severity of depression and anxiety with HADS scores. Residents varied in their sensitivity to their patients' depression and anxiety. There was no correlation between residents characteristic (gender and medical or surgical disciplines) and accuracy of probable diagnosis.
Conclusion: Medical and surgical residents routinely under-recognize depression and anxiety among inpatients in medical and surgical wards

Værøy H, Juell M, Høivik B. Prevalence of depression among general hospital surgical inpatients. Nord J Psychiatry 2003;57:13–16.

Arolt V, Fein A, Driessen M, et al. Depression and social functioning in general hospital inpatients. Journal of Psychosomatic Research 1998, 42:117–126.

Wancataa J,Windhabera J, Bacha M, et al. Recognition of psychiatric disorders in nonpsychiatric hospital wards. Journal of Psychosomatic Research 2000;48: 149–155.

Hansen MS, Fink P, Frydenberg M. Mental disorders among internal medical inpatients Prevalence, detection, and treatment status. Journal of Psychosomatic Research 2001; 50: 199- 204

Sharma P , Avasthi A, Chakrabartia S, Varmab S. Depression among hospitalised medically ill patients: a two-stage screening study. Journal of Affective Disorders 2002; 70: 205–209.

Rentsch D, Dumont P, Borgacci S, et al. Prevalence and treatment of depression in a hospital department of internal medicine. General Hospital Psychiatry 29 (2007) 25– 31.

Cassem EH. Depressive disorders in the medically ill. An overview. Psychosomatics 1995;36:2–10.

Staab JP, Datto CJ, Weinrieb RM, et al. Detection and diagnosis of psychiatric disorders in primary medical care settings. Med Clin North Am 2001;85(3):579– 97.

Diez-Quevedo C, Rangil T, Sanchez-Planell L, et al. Validation and utility of the Patient Health Questionnaire in diagnosing mental disorders in 1003 general hospital Spanish in-patients. Psychosom Med 2001;63:679– 86.

Januzzi JL, Stern TA, Pasternak RC, et al. The influence of anxiety and depression on outcomes of patients with coronary artery disease. Arch Intern Med 2000;160:1913– 21.

Lespe´rance F, Frasure-Smith N. Depression in patients with cardiac disease: a practical review. J Psychosom Res 2000;48:379– 91.

Saravay SM, Steinberg MD, Weinschel B, et al. Psychological comorbidity and length of stay in the general hospital. Am J Psychiatry 1991;148:324– 9.

Levenson JL, Hamer RM, Silverman JJ, et al. Psychopathology in medical inpatients and its relationship to length of hospital stay: a pilot study. Int J Psychiatry Med 1986– 87;16(3):231– 6.

Levenson JL, Hamer RM, Rossiter LF. Psychopathology and pain in medical in- patients predict resource use during hospitalisation but not rehospitalization. J Psychosom Res 1992;36(6):585–92.

Staab JP, Datto CJ, Weinrieb RM, et al. Detection and diagnosis of psychiatric disorders in primary medical care settings. Med Clin North Am 2001;85(3):579– 97.

Kathol RG, Wenzel RP. Natural history of symptoms of depressionand anxiety during in- patients treatments on general medicine wards. J Gen Intern Med 1992;7:287– 93.(Abstract)

Balestrieri M, Bisoffi G, deFrancesco M, et al. Six-month and 12-month mental health outcome of medical and surgical patients admitted to general hospital. Psychol Med 2000;30:359–67.

Balestrieri M, Bisoffi G, Tansella M, et al. Identification of depression by medical and surgical general hospital physicians. Gen Hosp Psychiatry 2002;24:4– 11.

Hermann C. international experiences with the hospital anxiety and depression scale: a review of validation data and clinical results. J Psychosomatic Res 1997;42: 1741.

Ali Montazeri, Mariam Vahdaninia, Mandana Ebrahimi, and Soghra Jarvandi: The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian Version. Health Qual Life Outcomes: v.1; 2003.

Thompson C, Kinmonth AL, Stevens L, et al. Effects of a clinical practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire Depression Project randomised controlled trial. Lancet 2000;355:185–91.

Wells KB, Sherbourne C, Schoenbaum M, et al.Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial. JAMA 2000;283:212–20.

Gilbody S, Sheldon T, Wessely S. Should we screen for depression? BMJ 2006;332;1027- 1030.

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IssueVol 4 No 1 (2009) QRcode
SectionArticles
Keywords
Anxiety Depression General hospital Recognition Residency

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How to Cite
1.
Soroush A-R, Rasooli F, Sharifi M, Bajoghli H, Nejatisafa A-A, Amini H. Recognition of Depression and Anxiety by Non-Psychiatric Residents in a General Hospital. Iran J Psychiatry. 1;4(1):41-43.