Chronic outcome of depression in medical patients: a six-month follow-up study

• Autores: Lily Sperry
• Directores de la Tesis: Antonio Bulbena Vilarrasa (dir. tes.)
• Lectura: En la Universitat Autònoma de Barcelona ( España ) en 2008
• Idioma: español
• Tribunal Calificador de la Tesis: Antonio Lobo Satué (presid.), Miquel Casas Brugué (secret.), Luis Miguel Martín López (voc.), J. M. Menchón Magriñá (voc.), Ada Inmaculada Ruiz Ripoll (voc.)
• Materias:
  • Ciencias médicas
    • Psiquiatría
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• Resumen

  • Objectives: The main objective of this study is to determine and describe the prevalence of undiagnosed and untreated depression in medical inpatients and evaluate outcome after a six-month follow-up.

    Subjects and Methods: This is a longitudinal, observational, blind, comparative case/non-case study with a baseline hospital two-stage screening phase and a six-month follow-up phase. A consecutive series of adult patients admitted to the internal medical inpatient ward were recruited. Selected patients were assessed in two phases; screened after admission and administered a psychiatric interview prior to discharge. A follow-up interview was administered at six months to evaluate outcome. Instruments used were standardized Spanish versions of the Mini-Mental State Examination, CAGE questionnaire, Hospital Anxiety and Depression Scale (HADS), Cumulative Illness Rating Scale, the Standardized Polyvalent Psychiatric Interview (SPPI), Quality of Life SF-36 survey, EuroQol-5D questionnaire and a modification of the Client Receipt Service Interview (CEUS). Measures include prevalence of depression, comparisons between cases and controls and outcome measures including prevalence of depression at six-month, chronicity rates for each diagnostic category and comparisons between remitted cases and chronic cases. Predictive values for the HADS questionnaire are calculated.

    Results: During the hospitalization phase 425 patients were selected for the study and 224 included and interviewed. The total prevalence of depression found was 19.4%. Major Depression was the most frequent diagnosis and represented 8.3%, Dysthimia 5.5% and Adjustment Disorder with Depressed Mood 5%. the total prevalence of psychiatric disorders was 26.9%, mainly composed of Adjustment Disorder with Mixed Anxiety and Depression Mood (6.7% of total). No significant differences were found between groups for socio-demographic or medical data. The case group did show a number of more severe psychiatric and somat