Detection Of Depression In Patients Research Articles

Depression screening in patients with coronary heart disease : Anarrative review of the current evidence.

In view of the large and sometimes conflicting body of research, this narrative review summarizes the current evidence on depression screening in patients with coronary heart disease. Depression is arisk factor for development and progression of coronary heart disease. Consequently, many international cardiac guidelines recommend screening for depression in patients with coronary heart disease. However, the efficacy and implementation of these guidelines are debated due to the lack of empirical evidence supporting the benefits of routine depression screening. Studies conducted in cardiac routine care support this assumption: Patients with positive depression screens do not receive adequate follow-up care, which highlights gaps in the detection-to-treatment pathway. Barriers to effective screening and treatment include system-level factors, such as insufficient integration of mental health resources in cardiology, and patient-related factors like stigma and low acceptance of mental health treatment. Innovative interventions that address these barriers and involve patients as active partners in depression care should be developed through atheory-driven, transparent, multistage process involving key stakeholders such as patients, nurses, and cardiologists. Asound methodological evaluation of such multilevel interventions could answer the question of whether early detection of depression in patients with coronary heart disease would lead to health benefits.

From accurate diagnosis to targeted therapy: depression in general medical practice

Objective: to analyze the diagnostic significance of clinical and phenomenological characteristics of affective disorders in patients with chronic somatic pathology.Patients and methods. The analysis included the results of a clinical evaluation of 131 patients with chronic somatic pathology, including 96 patients suffering from cardiovascular diseases and 35 patients with cerebral small vessel disease. Clinical assessment included Primary care evaluation of mental disorders (PRIME-MD) and Hamilton Depression Rating Scale.Results and discussion. Despite the significant frequency and transparent clinical symptoms, general practitioners diagnosed mental disorders in only 30% of patients with depression. We observed a higher prevalence of somatic rather than psychological complaints during the clinical survey. According to the screening using PRIME-MD, 74% of patients were diagnosed with mood disorders, anxiety, and somatoform disorders. We also noted their significant comorbidity with a predominance of a depression and anxiety combination (p < 0.001). Hypertensive patients had the highest depression prevalence (87%) and severity. Moderate depression was the most frequent diagnosis in the study participants, corresponding to major depressive disorder (61.5%).Conclusion. In general, the symptoms of anhedonia, depression, and anxiety were most pronounced in patients with affective disorders. The high prevalence of somatic symptoms complicates depression evaluation. It is possible to highlight depression and anhedonia as significant symptoms for the detection of depression in patients with somatic disorders.

Cut-off points for Polish-language versions of depression screening tools among patients with Type 2 diabetes

AimsScreening tools can help improve the detection of depression in patients with diabetes, yet the psychometric properties of most translations of scales, which are originally published in English, have not been assessed. Thus we studied the screening performance of widely used depression measures. MethodWe applied the cut-off points of the English-language versions of the Beck Depression Inventory (BDI); Hospital Anxiety and Depression Scale (HADS); Depression in Diabetes Self-Rating Scale (DDS-RS); Brief Self-Rating Scale of Depression and Anxiety (BS-RSDA); and Problematic Areas in Diabetes Survey (PAID), all of which were used to assess diabetes-specific distress in a sample of 101 patients with Type 2 diabetes. The Mini International Neuropsychiatric Interview and the Hamilton Depression Rating Scale (HDRS) were used to diagnose depression. ResultsWhen the English cut-off points were used, the tools had varied values of both sensitivity and specificity. When the best cut-off points were used, all measures had either very good or good sensitivity. Taking into account their length, the HADS and the BS-RSDA seem to be the best among the screening tools. ConclusionsEffective initial diagnosis of depression in patients with diabetes during a routine medical visit requires the use of screening tools that have adequate cut-off points.The analyses presented in this article show that screening tools should be validated and the cut-off points that are used should be population-specific.

Assessment and detection of depression in patients with coronary artery disease: validation of the Persian version of the PHQ-9

Background: Depression is a common comorbidity in patients with coronary artery disease (CAD), which often remains undetected and untreated.Objective: This study aimed to examine the psychometric properties of the Depression Module of the Patient Health Questionnaire (PHQ-9) on a sample of cardiac patients in Iran. Method: The Persian version of the PHQ-9 was developed and administered to 150 patients with CAD, admitted to a tertiary hospital in Tehran, Iran. The major depression module of the International Neuropsychiatric Interview (MINI) was used as the gold standard for the diagnosis of depression.Results: The Persian PHQ-9 demonstrated acceptable internal consistency, with Cronbach’s alpha coefficient of 0.80. The optimal cut-off score of ≥7 showed a sensitivity of 76, specificity of 78, and the area under curve of 0.82.Conclusion: The Persian PHQ-9 has acceptable psychometric properties to screen for and detect a current depressive episode in patients with CAD, with recommended cut-off score of ≥7.

Chronic Stress Disturbs Metabolome of Blood Plasma and Urine in Diabetic Rats.

About 30% of diabetes patients suffer from varying degrees of depression. Diabetes itself is associated with abnormal carbohydrate and energy metabolism. Whether chronic stress-induced depression-like behavior impacts the metabolome of blood plasma and urine in diabetes is not clear. This study aimed to investigate the effect of chronic stress on metabolome of plasma and urine in spontaneously diabetic Goto-Kakizaki (GK) rats. The GK rats were subjected to 8 weeks' chronic unpredictable mild stress (CUMS) to induce depression-like behavior. Metabolome analysis of blood plasma and urine using liquid chromatography mass spectrometry (LC/MS) was performed. Multivariate data analysis was used to evaluate the data. Behavior and biochemical assay confirmed the successful establishment of CUMS-induced depression-like behavior model in rats. Disturbance of 20 plasma metabolites and 16 urine metabolites were altered in CUMS-induced depression GK rats as compared to control ones. These disturbed metabolites were involved in fatty acid metabolism, sphingolipid metabolism, phenylalanine metabolism, citrate cycle, glycolysis, glutathione metabolism, and nicotinate and nicotinamide metabolism. This study suggest that chronic stress-induced depression-like behavior may further disturb diabetes-itself energy metabolome. The plasma and urine lipid metabolites monitoring may be useful for early detection of depression in patients with diabetes mellitus.

Sa1012 Integrated Pulmonary IndexTM Is a Simple and Valuable Assessment System for the Detection of Respiratory Depression in Patients Undergoing Sedation for Pancreatobiliary Endoscopy

Sa1012 Integrated Pulmonary IndexTM Is a Simple and Valuable Assessment System for the Detection of Respiratory Depression in Patients Undergoing Sedation for Pancreatobiliary Endoscopy

Knowledge and Attitude of 851 Nursing Personnel toward Depression in General Hospitals of Korea.

Our study aimed to examine the knowledge and attitude of nursing personnel toward depression in general hospitals of Korea. A total of 851 nursing personnel enrolled at four university-affiliated general hospitals completed self-report questionnaires. Chi-square tests were used to compare the knowledge and attitude of registered or assistant nurses toward depression. In addition, binary logistic regression analysis was used to adjust for the following confounders: age-group and workplace. Registered and assistant nurses differed in their knowledge and attitude toward depression. The proportion of rational and/or correct responses were higher in registered nurses than assistant nurses for the following: constellation of depressive symptoms defined by DSM-IV (adjusted odds ratio [aOR], 3.876; P<0.001); suicide risk in depression recovery (aOR, 3.223; P=0.001) and psychological stress as a cause of depression (aOR, 4.370; P<0.001); the relationship between chronic physical disease and depression (aOR, 8.984; P<0.001); and other items. Our results suggest that in terms of the biological model of depression, the understanding of registered nurses is greater than that of assistant nurses. Moreover, specific psychiatric education programs for nursing personnel need to be developed in Korea. Our findings can contribute to the development of a general hospital-based model for early detection of depression in patients with chronic medical diseases.

Consultation-liaison Approach for the Management of Psychiatric Manifestations in Parkinson's Disease and Related Disorders: A Report from Neuropsychiatric Hospital, India.

Background:Non-motor psychiatric manifestations of Parkinson's disease have been increasingly noted to contribute to morbidity and mortality.Materials and Methods:We studied the psychiatric manifestations among inpatients with Parkinson's disease and other movement disorders by examining the referrals (N = 127) to consultation-liaison psychiatry services from neurology/neurosurgery between July 2009 and April 2010 using structured clinical proforma.Results:Parkinson's disease and other movement disorders was the most common neurological diagnosis (19%). The most common reason for referral was depression (38%) followed by behavioral problems (33%). Post-assessment, depression rates were higher (54%) and behavioral manifestations were diagnosed as sleep problems (13%), organic psychiatric syndrome (13%), psychosis (8%), anxiety and obsessive compulsive disorder (8%), nil psychiatry (4%).Conclusion:Psychiatric comorbidity is high among in-patients with movement disorders and affective changes are common. Timely assessment using structured clinical proforma would help in enhanced detection of depression in patients with movement disorders.

Positive association between the plasma levels of 5-hydroxyindoleacetic acid and the severity of depression in patients with chronic obstructive pulmonary disease.

BackgroundThe role of plasma monoamines in patients with chronic obstructive pulmonary disease (COPD) with depression is unclear. To investigate monoamines in 20 depressed patients with COPD, the plasma concentrations of serotonin, 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid, and 3-methoxy-4-hydroxyphenylglycol (MHPG) were measured and compared with those in 50 non-depressed COPD patients, and also with 23 age- and gender-matched non-smokers and 13 smokers as non-depressed healthy controls.MethodsDiagnosis of depression was assessed using the Centre for Epidemiologic Studies Depression Scale. Plasma concentrations of monoamines were measured by high-performance liquid chromatography.ResultsNone of the depressed COPD patients had suicidal ideation. The plasma 5-HIAA level [median, (25% and 75% quartiles)] in depressed COPD patients [6.8 ng/mL, (4.9 and 13.1)] was significantly higher than in non-depressed COPD patients [5.4, (4.2 and 7.5)] (p=0.022) and non-smokers [5.1 (3.8 and 7.2)] (p=0.041), but not smokers [4.7, (4.0 and 6.7)] (p>0.05). The plasma 5-HIAA level (r=0.24, p=0.049) was significantly associated with the severity of depression in patients with COPD. The plasma MHPG level was significantly higher in depressed COPD patients (p=0.043) than in smokers, but was not higher than that in non-depressed COPD patients or non-smokers, although the level of MHPG was not associated with the severity of depression.ConclusionThe plasma 5-HIAA level is increased in depressed COPD patients. Plasma monoamines may be a good biomarker for detection of depression in patients with COPD.

Factors Influencing Depression among Elderly Patients in Geriatric Hospitals

[Purpose] The purpose of this study was to investigate the prevalence of depression among elderly patients and identify the factors influencing depression in a geriatric hospital in Korea. [Subjects] A self-report questionnaire was administered to the patients in community geriatric hospitals. Participants were 195 elderly patients. [Methods] The instruments utilized in this study were the Geriatric Depression Scale Short Form Korea (GDSSF-K), an activity of daily living scale, a self-esteem scale, a social support scale, and a life satisfaction scale. Data were collected from April 20 to June 20, 2011. Data were analyzed using descriptive statistics, Pearson correlations, and multiple logistic regression analysis using SPSS 15.0 and Stata 11.0. [Results] The average GDSSF-K score of the participants was 8.94, indicating a moderate level of depression. About 78.4% of the elderly patients in this study were classified as predisposed toward depression. Significant predictors for depression included the patients’ perceived health status and life satisfaction. [Conclusion] The results indicate that elderly patients face a high risk of developing depression and that efforts should be made to address it wherever possible. Regular depression screening will be beneficial for early detection of depression in patients at community geriatric hospitals.

Screening Instruments for Depression in Advanced Cancer Patients: What Do We Actually Measure?

Patients in a palliative care trajectory frequently suffer from depression. To distinguish depression from normal sadness, the use of screening instruments could facilitate the diagnostic process. However, in palliative care, screening instruments may not discern physical symptom burden from psychological distress, due to the high number of physical symptoms in palliative patients. The aim of this study was to explore physical symptom burden and psychological distress in patients with advanced cancer in relation to scores on screening instruments for depression. Patients with advanced cancer were asked to fill out the Beck Depression Inventory (BDI-II), Beck Depression Inventory Primary Care (BDI-PC), Hospital Anxiety and Depression Scale (HADS), and Memorial Symptom Assessment Scale Short Form (MSAS-SF). The relationship between scores on screening tools for depression and different physical symptom clusters was explored. In the sample of 65 patients, screening instruments for depression correlated highly with different somatic symptom clusters. The BDI-II cognitive subscale was the only scale that was not significantly correlated with any of the somatic symptom clusters. Screening tools for the detection of depression in patients with advanced cancer may not provide an accurate evaluation of depression. These tools seem to measure physical symptom burden as well, especially when patients suffer from symptoms of the clusters fatigue/anorexia/cachexia, neuropsychology, debility, or pain. In this study, the BDI-II cognitive subscale seems to differentiate best from somatic symptom burden.

Detection of Depression in Patients with Low Vision

Depression is common in people with vision impairment and further reduces levels of functioning independent of vision loss. However, depression most often remains undetected and untreated this group. Eye health professionals (EHPs) (ophthalmic nurses, ophthalmologists, optometrists, and orthoptists) and rehabilitation workers (RWs) may be able to play a role in detecting depression. This study aimed to identify current practice and investigate factors associated with depression management strategies. A self-administered cross-sectional survey of EHPs and RWs assessed current practice including confidence in working with depressed people with vision impairment; barriers to recognition, assessment, and management of depression; beliefs about the consequences, duration, and efficacy of treatment for depression in individuals with vision impairment. Ninety-four participants aged 23 to 69 years took part. Thirty-seven participants (39.8%) stated that they attempted to identify depression as part of patient management, with RWs significantly more likely to do so (n = 17, 60.7%) than EHPs (n = 20, 30.8%; p = 0.007). Intention to identify depression was not associated with sociodemographic factors, professional experience in eye care services, or the length and number of patient consultations, but a significant relationship was found for confidence, barriers, and beliefs about depression (p < 0.05). No consistent depression management strategy emerged and a range of barriers were highlighted. Training programs are needed to provide EHPs and RWs with the skills and resources to address depression in people with vision loss under their care and to support the development of procedures by which concerns about depression can be identified objectively, documented, and included as part of a referral to appropriate services.

A Comparison of Capnography and Pulse Oximetry for the Detection of Respiratory Depression in Patients Undergoing Gastrointestinal Endoscopy

A Comparison of Capnography and Pulse Oximetry for the Detection of Respiratory Depression in Patients Undergoing Gastrointestinal Endoscopy

Detection of depression in patients in emergency wards using the GDS-30

Materials and methods Elderly patients(65 years of age; n = 473), visiting Emergency Department, complaining for chest pain, without coronary heart disease (normal ECG, without elevation of CK-MB and Troponin) were rated by General Practitioner using the GDS-30.Their mean age ± standard deviations was 69.8 ± 7.7 (male 70.1 ± 7.7; and female 68.7 ± 7.5) years.In the first phase, the patients completed the GDS, the Mini-Mental State Examination (M.M.S.E.) and a questionnaire on health and sociodemographic variables. They were interviewed using the Geriatric Mental Schedule (GMS), used by doctor who was unaware of the results of the GDS. Two categories were contemplated according to the results of the GMS: cases of depression (diagnosis of psychotic or neurotic depression) and nonpsychiatric cases.

Detection of depression in elderly hospitalized patients in emergency wards in France using the CES-D and the mini-GDS: preliminary experiences.

The purpose of this study was to evaluate the mini-GDS and the CES-D as instruments to detect depression in elderly hospitalized patients in emergency wards in France. The CES-D was used on two cohorts of 60 non-cognitively impaired patients aged 70 or more. The mini-GDS was also used on the second of the two cohorts administered by a medical intern. These ratings were compared with a diagnosis of depressive disorder by ICD-10 criteria. The study population had a high (58%) prevalence of depression and a low level of active psychiatric referral. Mini-GDS and CES-D scores were well correlated (0.72, p < 0.001); the mini-GDS, with a cutoff score of 1, gave optimum sensitivity (88%) and specificity (63%). The use of the mini-GDS may aid the detection of depression in patients in emergency wards.

The Importance of Identifying Depression in Patients with Rheumatoid Arthritis

Depression is common in patients with chronic illness including rheumatoid arthritis (RA). Identifying depression accurately and treating it appropriately are important for helping to maintain function in patients with RA. Several self-administered screening tools are available that are sensitive for the detection of depression in medical outpatients and are easy to use in a clinic setting. There has been debate regarding the validity of some of these tools for detecting depression in RA patients because of "arthritis-biased" questions. In this study, we evaluated 77 patients with RA and measured their responses to one of these screening tools, the Beck Depression Inventory (BDI). We compared disease activity and severity measures and measures of functional status between patients who were designated as depressed by BDI score and patients without depressive symptoms.We were unable to demonstrate differences in specific objective measures of disease activity, severity, or objective functional measures between nondepressed and depressed RA patients. However, depressed patients reported greater disease activity and poorer physical function, and observer global assessment of depressed patients was poorer. We conclude that the "arthritis-biased" questions in the BDI did not interfere with the detection of depression in patients with RA and should not be a deterrent for its use. We found that the BDI can be used effectively in a clinic setting as a screening tool for depression in patients with RA.