Resumen de Depression in internal medicine inpatients at the time of hospital discharge and referral to primary care
María Fe Barcones, Antonio Bulbena Vilarrasa, Antonio Campayo, Ricardo Campos Ródenas, M. Lozano Suárez, Alberto Cebollada Gracia, Joan de Pablo Rabassó, José María Farré Martí, Eduardo García-Camba de la Muela, Javier García Campayo, Manuel Girón Giménez, Elena Lobo, Guillermo Marcos Aragües, C. Mingote Adán, Luis Salvador Carulla, J. Santabarbara, Pedro Saz Muñoz, Antonio Lobo Satué
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.
