Depression among hospitalised medically ill patients: a two-stage screening study

Abstract 

Background: There is wide variability in prevalence of depression in the physically ill. Moreover, data from the developing world is scarce. Methods: Consecutive patients between the age 20–60 years and excluding those with malignancies and neurological illnesses, admitted to medical units (N=176), were screened with Beck’s Depression Inventory (BDI). Those scoring more than 10 on BDI (N=55) were assessed with the Schedule for Clinical Assessment in Neuropsychiatry (SCAN). Age/sex matched healthy relatives served as controls. Results: Thirty two percent (32%) of patients scored more than 10 on the BDI. None among controls scored more than the cut-off on BDI. Second-stage screening with SCAN on 33 subjects yielded a figure of 17% for depressive syndrome among the physically ill. Depression was mostly of the mild to moderate variety. Conclusions: High rates of depression were detected among physically ill hospitalised patients. Perhaps, differences in instruments used and population screened accounted for this. Clinical implications: Need for increasing awareness as well as improving methods of detecting depression in physically ill is underscored. Limitations: a significant number of patients who screened positive on the BDI could not be interviewed with the SCAN for various reasons. Thus figures obtained after second stage screening are likely to be an underestimate.

Keywords:  Depression, Physical illness, Two-stage screening