title: Depression, alcohol use disorders and nicotine dependence among patients at a general hospital.
abstract: OBJECTIVE
  To determine prevalence rates and identify patient characteristics associated with depression, alcohol use disorders and nicotine dependence among individuals admitted to a general teaching hospital.
  
  
  METHODS
  Using the Hospital Anxiety and Depression Scale and Alcohol Use Disorder Identification Test, we assessed 4,352 consecutive medical and surgical patients admitted over a 13-month period. The patients were also asked to report their daily cigarette smoking habits during the last month. Multiple logistic regression analyses were performed, and odds ratios (ORs) were calculated.
  
  
  RESULTS
  The mean age of the sample was 49.3 years, and 56.6% were male. Prevalence rates of depression, alcohol use disorders and nicotine dependence were, respectively, 14%, 9.8% and 16.9%. In the multivariate analysis, depression was associated with previous suicide attempts (OR = 8.7), lower level of education (OR = 3.6), prior use of psychotropic medications (OR = 3.1), cancer (OR = 1.7) and pain (OR = 1.7). Alcohol use disorders were associated with male sex (OR = 6.3), smoking (OR = 3.5), admission for an external cause of injury, such as a traffic accident (OR = 2.4), and previous suicide attempts (OR = 2.3). Nicotine dependence was associated with alcohol use disorders (OR = 3.4), young adulthood (OR = 2.3), widowhood (OR = 2.2) and previous suicide attempts (OR = 1.8).
  
  
  CONCLUSIONS
  This is the largest sample of medical and surgical patients ever surveyed with standardized screening instruments in a general hospital in Brazil. The high prevalence rates of psychiatric disorders and the profiles of the patients evaluated in this study underscore the need to develop methods that are more effective for detecting and managing such disorders. Hospital admission should be considered a major opportunity for the detection of psychiatric disorders and the subsequent implementation of the appropriate specific treatment strategies.
authors.affiliation: Department of Medical Psychology and Psychiatry, UNICAMP, Campinas, SP, Brazil. botega@fcm.unicamp.br
authors.forename: Neury José
authors.initials: NJ
authors.lastname: Botega
authors.forename: Gabriela Nero
authors.initials: GN
authors.lastname: Mitsuushi
authors.forename: Renata Cruz Soares de
authors.initials: RC
authors.lastname: Azevedo
authors.forename: Daniela Dantas
authors.initials: DD
authors.lastname: Lima
authors.forename: Priscila Caroline
authors.initials: PC
authors.lastname: Fanger
authors.forename: Marisa Lúcia Fabrício
authors.initials: ML
authors.lastname: Mauro
authors.forename: Karla Cristina
authors.initials: KC
authors.lastname: Gaspar
authors.forename: Viviane Franco da
authors.initials: VF
authors.lastname: Silva
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D055815:Young Adult