title: Major depression in hospitalized Argentine general medical patients: Prevalence and risk factors.
abstract: BACKGROUND
  Depression is not uncommon among medically hospitalized patients, though reported prevalence has varied widely, often in samples involving elderly patients with particular illnesses. Accordingly, we evaluated risk of major depression in three metropolitan general hospitals in Buenos Aires, in subjects with a range of medical disorders and ages, comparing several standard screening methods to expert clinical examinations.
  
  
  METHODS
  Consecutively hospitalized general medical patients were evaluated over a six-months. Excluded were subjects under age 18 and those unable to participate in assessments because of illness, medication, sensory or speech impairment, or lack of language fluency, or scored <25 on the Mini Mental State Examination (MMSE). Consenting participants were examined for DSM-IV-TR major depression by psychiatrists guided by MINI examinations, compared with other standard screening methods. Risk factors were assessed by preliminary bivariate analyses followed by multivariate logistic regression modeling.
  
  
  RESULTS
  Overall prevalence of major depression in 257 subjects was 27% by psychiatric examination. The rate was most similar (25%) with the Hospital Anxiety & Depression Scale (HADS), and much higher with the Beck Depression Inventory-II (BDI, 44%) and Patient Health Questionnaire (PHQ, 56%). Factors associated independently with depression by multivariate modeling included: prior psychotropic-drug treatment, female sex, more children, and heavy smoking. Depression was associated most with neoplastic, urological, and infectious disorders, least with pulmonary, neurological, and hematologic conditions.
  
  
  CONCLUSIONS
  Modest numbers limited power to test for associations of depression with specific medical conditions.
  
  
  CONCLUSIONS
  Major depression was identified in over one-quarter of Argentine, general medical inpatients, with marked differences among screening methods. Several risk factors were identified. The findings encourage assertive identification of depression in hospitalized medical patients using valid, reliable, and cost-effective means of improving their care.
authors.affiliation: Hospital Interzonal De Agudos Eva Perón, San Martín, Buenos Aires, Argentina.
authors.forename: Andrés
authors.initials: A
authors.lastname: Yanzón de la Torre
authors.affiliation: Hospital General de Agudos Bernardino Rivadavia, CABA, Argentina.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Oliva
authors.affiliation: Hospital Municipal Bernardo A. Houssay, Vicente López, Buenos Aires, Argentina.
authors.forename: Paula L
authors.initials: PL
authors.lastname: Echevarrieta
authors.affiliation: Hospital Municipal Bernardo A. Houssay, Vicente López, Buenos Aires, Argentina.
authors.forename: Bibiana G
authors.initials: BG
authors.lastname: Pérez
authors.affiliation: Hospital Interzonal De Agudos Eva Perón, San Martín, Buenos Aires, Argentina.
authors.forename: Gabriela B
authors.initials: GB
authors.lastname: Caporusso
authors.affiliation: Hospital Interzonal De Agudos Eva Perón, San Martín, Buenos Aires, Argentina.
authors.forename: Anabella J
authors.initials: AJ
authors.lastname: Titaro
authors.affiliation: Hospital Interzonal De Agudos Eva Perón, San Martín, Buenos Aires, Argentina.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Todaro Kicyla
authors.affiliation: Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
authors.forename: Mariana
authors.initials: M
authors.lastname: Cuatz
authors.affiliation: Hospital General de Agudos Bernardino Rivadavia, CABA, Argentina.
authors.forename: Mariana
authors.initials: M
authors.lastname: Locatelli
authors.affiliation: Hospital General de Agudos Bernardino Rivadavia, CABA, Argentina.
authors.forename: Lucila M
authors.initials: LM
authors.lastname: Nelson
authors.affiliation: Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Mac Mullen
authors.affiliation: International Consortium for Mood & Psychotic Disorders Research, McLean Hospital, Harvard Medical School, Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
authors.affiliation: Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina. Electronic address: fdaray@hotmail.com.
authors.forename: Federico M
authors.initials: FM
authors.lastname: Daray
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use; D015203:Reproducibility of Results; D012307:Risk Factors; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: Depression; General hospital; Prevalence; Risk factors