Depression among patients admitted to medical wards: comparison between a university hospital and regional hospital

Wipawee Hantrakul,Wittaya Wangsomboonsiri,Chutintorn Sriphrapradang

doi:10.1515/openhe-2020-0002

Wipawee Hantrakul, Wittaya Wangsomboonsiri + Show 1 more

Open Access

https://doi.org/10.1515/openhe-2020-0002

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Abstract

Abstract Objective: We aimed to determine the prevalence of depression and to find factors associated with depression in admitted medical patients. The differences in the pattern of depression between a university hospital (UH) and a regional hospital (RH) were determined as well. Methods: This is a cross-sectional study. The Patient Health Questionnaire-9 (PHQ-9) was administered among hospitalized patients in medical wards. PHQ-9 could not differentiate between the type of depressive disorder that could be from medical conditions, adjustment disorder with depressed mood, major depressive disorder, or dysthymia. Results: A total of 343 patients (191 in UH, 152 in RH group) with age of 52.1 ± 16.9 years were included. Timing of interview was 4.3 ± 1.4 days after admission. The prevalence of depression (PHQ-9 score ≥ 9) was 12% (7.3% in UH vs 17.8% in RH, p < 0.005). According to PHQ-9 scoring, the prevalence of moderate-to-severe depression was 3.8%. Mean PHQ-9 score in RH was significantly higher than in UH (p < 0.001). Multiple baseline characteristics were analyzed by logistic regression and found no factors associated with depression. There was no difference in baseline characteristics of UH patients with depression compared to RH, except for universal health coverage plan. Conclusions: The prevalence of depression was 1 in 10 patients and was found to be more frequent and severe in RH than UH. All patients were at equal risk to develop depression during admission.

Highlights

Depression refers to a common mental health problem characterized by a wide spectrum of symptoms, including the depressed mood, absence of interest or pleasure, loss of energy, feelings of guilt or low self-esteem, poor concentration, altered appetite, and disturbed sleep [1]
Multiple baseline characteristics were analyzed by logistic regression and found no factors associated with depression
There was no difference in baseline characteristics of university hospital (UH) patients with depression compared to regional hospital (RH), except for universal health coverage plan

Summary

Introduction

Depression refers to a common mental health problem characterized by a wide spectrum of symptoms, including the depressed mood, absence of interest or pleasure, loss of energy, feelings of guilt or low self-esteem, poor concentration, altered appetite, and disturbed sleep [1]. Depressive mood is an emotional state which is experienced by most people with poor physical health. Based on 20 studies, the median prevalence of depression in hospitalized medical patients was 33%, ranging from 15-60% [6]. Many mental disorders can occur after stressful events, including anxiety, depression, psychosis and post-traumatic stress disorder [5,7]. The frequency of anxiety, depression and post-traumatic stress disorder among the survivors of critical illness was 46%, 40% and 22%, respectively [7]. The prevalence of depression among patients with myocardial infarction was high as 29% and may lead to poor long-term quality of life and increased cardiac mortality [9,10]. Many studies found depression is associated with poorer physical health, worse functional

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