Symptoms of depression and anxiety (MHI) following acute medical/surgical hospitalization and post-discharge psychiatric diagnoses (DSM) in 839 geriatric US veterans

✍ Scribed by Sylvia Gerson; Ritesh Mistry; Roshan Bastani; Fred Blow; Robert Gould; Maria Llorente; Annette Maxwell; Jennifer Moye; Edwin Olsen; Robert Rohrbaugh; Joel Rosansky; William Van Stone; Lissy Jarvik

• Publisher: John Wiley and Sons
• Year: 2004
• Tongue: English
• Weight: 126 KB
• Volume: 19
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.1217

✦ Synopsis

Abstract

Objective

We addressed the relatively unexplored use of screening scores measuring symptoms of depression and/or anxiety to aid in identifying patients at increased risk for post‐discharge DSM‐IV Axis I diagnoses. We were unable to find such studies in the literature.

Method

Elderly veterans without recent psychiatric diagnoses were screened for depression and anxiety symptoms upon admission to acute medical/surgical units using the Mental Health Inventory (MHI). Following discharge, those who had exceeded cut‐off scores and had been randomized to UPBEAT Care (Unified Psychogeriatric Biopsychosocial Evaluation and Treatment, a clinical demonstration project) were evaluated for DSM diagnoses. We report on 839 patients, mostly male (96.3%; mean age 69.6 ± 6.7 years), comparing three groups, i.e. those meeting screening criteria for symptoms of (i) depression only; (ii) anxiety only; and (iii) both depression and anxiety.

Results

Despite absence of recent psychiatric history, 58.6% of the 839 patients received a DSM diagnosis post‐discharge (21.8% adjustment; 15.4% anxiety; 7.5% mood; and 14.0% other disorders). Patients meeting screening criteria for both depression and anxiety symptoms received a DSM diagnosis more frequently than those meeting criteria for anxiety symptoms only (61.9% vs 49.0%, p = 0.017), but did not differ significantly from those meeting criteria for depressive symptoms only (61.9% vs 56.8%, p = 0.174). Although exceeding the MHI screening cut‐off scores for depression, anxiety, or both helped to identify patients with a post‐discharge DSM diagnosis, the actual MHI screening scores failed to do so.

Conclusion

Screening hospitalized medical/surgical patients for symptoms of depression, anxiety, and particularly for the combination thereof, may help identify those with increased risk of subsequent DSM diagnoses, including adjustment disorder. Copyright © 2004 John Wiley & Sons, Ltd.