Produção Nacional
Revisado por pares
Depression in general hospital inpatients: challenges for consultation-liaison psychiatry
2011; Associação Brasileira de Psiquiatria; Volume: 33; Issue: 3 Linguagem: Inglês
10.1590/s1516-44462011000300016
ISSN1809-452X
AutoresKarla Cristina Gaspar, Amilton dos Santos Júnior, Renata Cruz Soares de Azevedo, Marisa Lúcia Fabrício Mauro, Neury José Botega,
Tópico(s)Cardiac Health and Mental Health
ResumoDepression in general hospital inpatients: challenges for consultation-liaison psychiatry Depressão em pacientes internados em hospital geral: desafios para a interconsulta psiquiátricaDear Editor, Nearly one-fourth of medical and surgical inpatients in general hospitals match criteria for depressive disorders 1 .The odds ratio for depression gets higher as the number of chronic diseases increases.Besides, such comorbidities aggravate one another 2 .The Study of Brief Opportunity Intervention (EIBO, in the Portuguese acronym) performed a series of randomized clinical trials with patients admitted to the Clinical Hospital of the State University of Campinas (UNICAMP) in Brazil 3,4 .As part of this research project we screened all patients by means of the Hospital Anxiety and Depression Scale (HAD).The first 50 cases of depressive episode confirmed by the Mini International Neuropsychiatric Interview were given standardized information about depression and referred to a public health service to start treatment for depressive disorder.Because of the naturalistic nature of the present study, there was no interference on the assistant doctors' treatment provided to patients during hospitalization.After six months of hospital discharge, all the patients were reassessed by a telephone interview.In spite of the limitations of this assessment strategy, it made possible to contact (or have news from) all patients, including those living far from the hospital.The criterion used for depression improvement was a decrease of at least 50% on the HAD depression score.Statistical analyses were performed using STATA version 7.0.Patients' mean age was 49.3 years old (standard deviation: 14.5).Infections, malign neoplasms, renal and gastrointestinal diseases were the major reasons for hospitalization, most of which were associated with underlying diseases (mainly high blood pressure, diabetes and heart diseases).After six months of discharge, five patients died, six could not be contacted by telephone and one refused to participate in a new interview.Out of 38 reassessed patients, 44.7% received treatment for depression, 58% of whom an antidepressant medication.Two-thirds continued depressed.In this group there were fewer reports of pain and more previous suicidal behavior at the baseline assessment (see Table 1).It might be that those in pain received more treatment/analgesics for the underlying disease and that the pain relief was followed by fewer reports of depressive symptoms at the follow-up assessment.
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