Evaluating psychiatric morbidity in a general hospital: a two-phase epidemiological survey.
BACKGROUND
This study aimed to assess psychiatric morbidity and to collect information on disability, life events and family support in a representative sample of patients admitted to a general hospital.


METHODS
On the basis of information collected in a pilot study a systematic sample of patients consecutively admitted to seven general medical and seven surgical wards of the Academic General Hospital of Verona was selected and interviewed using a two-phase screening procedure and standardized instruments (GHQ-12, HADS, BDQ and CIDI-PHC). All data were analysed using appropriately weighted logistic regression procedures.


RESULTS
A total of 1039 patients completed the GHQ-12 and 298 (28.7%) were high-scorers: 363 patients were interviewed with CIDI-PHC. The prevalence of ICD-10 cases was 26.1%. The most common psychiatric diagnoses were current depression (12.8%) and generalized anxiety disorder (10.8%), followed by alcohol related disorders (5 %). A higher prevalence of ICD-10 cases was found in medical wards, among females, patients older than 24 years, unemployed and separated/divorced people. Life events were associated with psychopathology, and so was the number of disability days. Although 49.8% of ICD-10 cases were identified by the hospital doctors as having a psychological disorder, 23.1% of ICD-10 cases were referred to the liaison psychiatric service.


CONCLUSIONS
The results of the present study stress the need to collect epidemiologically-based data on psychological disorders and their recognition not only in general practice, but also in general hospital settings, in order to have a more complete picture of the pathways to specialist care.
Martucci
M
M
Istituto di Psichiatria, Università di Verona, Italy.
Balestrieri
M
M
Bisoffi
G
G
Bonizzato
P
P
Covre
M G
MG
Cunico
L
L
De Francesco
M
M
Marinoni
M G
MG
Mosciaro
C
C
Piccinelli
M
M
Vaccari
L
L
Tansella
M
M
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D012944:Social Support