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

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.

Long-term psychopathology changes among the injured and members of the community after a massive terrorist attack.

BACKGROUND AND AIM: To document long-term prevalence trends and changes in post-traumatic stress disorder (PTSD), current major depression (MD), agoraphobia, generalized anxiety disorder (GAD), and panic disorder, in two groups of people with different levels of exposure to a massive terrorist attack. METHODS: Cohort study. Two random samples of people exposed to a terrorist attack, the injured (n=127) and community residents (n=485) were followed and assessed, 2 and 18 months after the event. RESULTS: Among the injured, 2 and 18 months after the attack, the prevalences were respectively, PTSD: 44.1% and 34%, MD: 31.5% and 23.7%, agoraphobia: 23.8% and 20.7%, GAD: 13.4% and 12.4% and panic disorder: 9.4% and 11.3%. The corresponding figures among residents were PTSD: 12.3% and 3.5%, MD: 8.5% and 5.4%, agoraphobia: 10.5% and 8.7%, GAD: 8.6%, and 8.2% and panic disorder 2.1% and 2.7%. CONCLUSIONS: Two months after the event, the prevalence of mental disorders among both injured and residents was higher than expected levels at baseline conditions. Eighteen months after the event, psychopathological conditions did not change significantly among the injured but returned to the expected baseline rates among community residents.

Spanish perspective on enlarging a small specialty: the national research network for liaison psychiatry and psychosomatics.

The Spanish Research Network in Liaison Psychiatry and Psychosomatics (REPEP) comprises 11 centers (nodes), and was one of the successful applicants in a very competitive call for a networking program for the National Institute of Health "Carlos III" project. This article describes its general objectives and strategic plans. Both qualitative and quantitative results support our statement that this "perspective" should help to enlarge what is presently a small specialty. Synergies in the network have been potentiated; an ambitious national study on depressive comorbidity in complex medical patients has been executed; and new research and training programs have been initiated.

Síndrome de Cushing: un caso de esquizofrenia resecable / Cushing´s syndrome: a case of resecable schizophrenia

No disponible