Screening for anxiety and depression in adult general medical in-patients in a Scottish District General Hospital.

Abstract

We prospectively screened for anxiety and depression by administering the HAD scale to consecutive general medical patients admitted to a Scottish District General Hospital (DGH) over a calendar month. Age, gender, and use of psychotropic medications were also recorded. Of 119 patients (49 male) aged 16 to 92 years, "Probable presence of anxiety" was recorded in 23%, and "Probable presence of depression" in 19%. There was no significant difference between male and female patients or between different age groups. Formal psychological management was not available on site. Sixty-seven per cent of patients with "Probable presence of anxiety" and 61% with "Probable presence of depression" received no psychotropic medications. Despite a high prevalence of psychological distress amongst general medical in-patients, anxiety and depression are consistently under-diagnosed and under-treated. Screening for psychological distress, followed, where indicated, by psychological and/or pharmacological intervention, should be a fundamental element of holistic, patient-centred care in general medicine.