Depressed mood, physician-rated prognosis, and comorbidity as independent predictors of 1-year mortality in consecutive medical inpatients.
OBJECTIVE
To determine the independent effects of depressed mood and markers of medical disease severity on mortality in consecutive medical inpatients.


METHODS
Consecutive general medical inpatients were asked to complete the Hospital Anxiety and Depression Scale (HADS) at admission. Prognostic indicators were obtained from patients' records and physicians' ratings. The study endpoint was mortality from all causes at 1 year.


RESULTS
The baseline assessment was completed by 575 patients (87.7%). Survival data were available for 572 of these (86 deaths). HADS depression scores and several physical risk indicators predicted mortality. In multivariate analyses, physicians' rating of prognosis was the best predictor of mortality [adjusted odds ratio (OR) 3.6; 95% confidence interval (CI), 2.5--5.4]. Other independent predictors included a principal diagnosis of hemato-oncological disease, comorbidity scores, and HADS depression (adjusted OR 1.75; 95% CI, 1.10--2.79).


CONCLUSIONS
Our data demonstrate an independent prognostic effect of depressed mood on mortality in general medical inpatients. Screening for depression may improve risk stratification in these patients over and above that obtained by routinely available physical parameters and physicians' clinical judgement.
Herrmann-Lingen
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Department of Psychosomatic Medicine, University of Göttingen, von-Siebold Str. 5, D-37075 Göttingen, Germany. cherrma@gwdg.de
Klemme
H
H
Meyer
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D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000401:mortality* / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010348:Patient Care Team; D010555:Personality Inventory; D011379:Prognosis; D012803:Sick Role; D016019:Survival Analysis