[Validation of an observer-based rating set compared to a standardized written psychological test for the diagnosis of depression and anxiety in a university preadmission test center].
BACKGROUND
Depression and anxiety can be a major factor of perioperative stress and might contribute to patients dissatisfaction with medical care if they remain unrecognized. There are several methods to diagnose depression and anxiety like standardized written psychological tests or self report scales. Because these tests are not always suitable for routine use in a busy preadmission test center we evaluated an observer-based rating set for the diagnosis of depression and anxiety.


METHODS
70 patients of a university hospital preadmission test center were tested with the HADS-D-Test and the observer-based rating set after approval of the institutional review board and written informed consent. Test-data were compared using a logistic regression model and demographic variables were analyzed using t-Test. ANOVA and Pearson correlation.


RESULTS
The prevalence of depression in our study population was 11.11% (14.75% in male, 9.76% in female) and the prevalence of anxiety was 7.14% (6.9% in male and 7.32% in female). The correlation between the observer-based rating items and the HADS-D-diagnosis was statistically highly significant. The observer based items "unsteady eye movements" and "general worrisome mood" proved to be especially sensitive for anxiety and the items "sorrowful mood" and "impression of resignation" were sensitive for depression without any influence of the experience of the anesthesiologist. A higher prevalence of depression and anxiety was found in patients with ASA-class III compared to those with ASA-classes I and II while age and type of surgery had no significant influence.


CONCLUSIONS
Based on our observations depression and anxiety are a relevant factor of preoperative morbidity assessment. Observer-based items are a reliable tool to detect those patients which might need special assistance and therapy in the perioperative period to reduce stress associated with high preexisting levels of depression and anxiety.
Schulz-Stübner
S
S
Klinik für Anästhesiologie am Universitätsklinikum der RWTH Aachen. schust@t-online.de
de Bruin
J
J
Neuser
J
J
Rossaint
R
R
D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis* / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D003955:Diagnostic Tests, Routine; D005260:Female; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D008297:Male; D011300:Preoperative Care / Q000523:psychology*; D015995:Prevalence; D011581:Psychological Tests; D012044:Regression Analysis; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires