Depressive co-morbidity in medical in-patients at the time of hospital discharge and outcome in a Primary Care follow-up. I. Rational and design of the project
Eur. j. psychiatry
; 19(3): 172-192, jul.-sept. 2005. tab
Article
in En
| IBECS
| ID: ibc-044271
Responsible library:
ES1.1
Localization: ES1.1 - BNCS
RESUMEN
Objectives:
In a context of a continuity of care model in Psychosomatic and Liaison Psychiatry, this study is intended to test, in patients to be discharged from Medicine wards, hypotheses related to a high prevalence of depression and, in particular, its negative outcome at six-months follow-up in Primary Care (PC), especially among the elderly.Methods:
Sample. Consecutive patients aged 18 years or more, hospitalized in Medicine wards were randomly selected for screening at the time of admission. On the bases of a previous study and the expected sampling errors, sample size was estimated in 700patients (approximately 60% in geriatric age) for the initial screening, to recruit 75 or more cases of depression and enough number of control, non-cases without psychiatric morbidity..Instruments. Standardized, Spanish versions of screening/case-finding instruments COMPRI/INTERMED, Mini-Mental, CAGE and drug screening, Hospital Anxiety and Depression Scale (HADS), Standardized Polyvalent Psychiatric Interview (SPPI). Diagnostic criteria ICD-10 research, medical patients version and DSM-IV-TR (psychiatric);and ICD-9-M; ICHPPC, WONCA (medical). Cumulative Illness Rating Scale (CIRS)(severity of physical condition); SF36 and EuroQol (quality of life); Client Service Receipt Interview (CSRI) (costs).Procedure. Part I, hospital study Two-phase screening (lay interviewers COMPRI/INTERMED at admission; Mini-Mental, CAGE, HADS at the time of discharge; and standardized clinicians SPPI). CIRS was used to control severity of physical conditions. Part II, follow-up study in PC (six months) Standardized clinicians, blind to the previous phases (HADS and SPPI to both cases and controls). Outcome study Euro-Quol, SF36, CSRI and data on morbidity and mortality, were collected. Conclusions. To our knowledge, this is the first study using modern epidemiological methods in medical patients to be discharged with co-morbid depression and followed in PC with a continuity of care strategy. The final analysis of data should support the design of an evidence-based, intervention study on co-morbid depression (AU)
Full text:
Available
Collection:
National databases
/
Spain
Health context:
SDG3 - Target 3.8 Achieve universal access to health
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SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Delivery Arrangements
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Mental Health and Behavioral Disorders
Database:
IBECS
Main subject:
Continuity of Patient Care
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Depressive Disorder
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Hospitalization
Type of study:
Observational study
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Prognostic study
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Risk factors
Aspects:
Patient-preference
Limits:
Adult
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Aged
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Female
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Humans
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Male
Language:
English
Journal:
Eur. j. psychiatry
Year:
2005
Document type:
Article
Institution/Affiliation country:
Hospital Universitario "Miguel Servet"/España
/
Universidad de Zaragoza/España