Screening for depression in hospitalized medical patients.
Depression among hospitalized patients is often unrecognized, undiagnosed, and therefore untreated. Little is known about the feasibility of screening for depression during hospitalization, or whether depression is associated with poorer outcomes, longer hospital stays, and higher readmission rates. We searched PubMed and PsycINFO for published, peer-reviewed articles in English (1990-2016) using search terms designed to capture studies that tested the performance of depression screening tools in inpatient settings and studies that examined associations between depression detected during hospitalization and clinical or utilization outcomes. Two investigators reviewed each full-text article and extracted data. The prevalence of depression ranged from 5% to 60%, with a median of 33%, among hospitalized patients. Several screening tools identified showed high sensitivity and specificity, even when self-administered by patients or when abbreviated versions were administered by individuals without formal training. With regard to outcomes, studies from several individual hospitals found depression to be associated with poorer functional outcomes, worse physical health, and returns to the hospital after discharge. These findings suggest that depression screening may be feasible in the inpatient setting, and that more research is warranted to determine whether screening for and treating depression during hospitalization can improve patient outcomes. Journal of Hospital Medicine 2017;12:118-125.
Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, Los Angeles, CA, USA.|Cedars-Sinai Medical Center, Department of Health Sciences, Los Angeles, CA, USA.|David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Waguih William
WW
IsHak
Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, Los Angeles, CA, USA.|Purdue University, West Lafayette, Indiana, USA.
Katherine
K
Collison
Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, Los Angeles, CA, USA.
Itai
I
Danovitch
Cedars-Sinai Medical Center, Department of Internal Medicine, Los Angeles, CA, USA.
Lili
L
Shek
Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, Los Angeles, CA, USA.
Payam
P
Kharazi
Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, Los Angeles, CA, USA.|Western University, Los Angeles, CA, USA.
Tae
T
Kim
Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, Los Angeles, CA, USA.|Cairo University School of Medicine, Cairo, Egypt, USA.
Karim Y
KY
Jaffer
Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, Los Angeles, CA, USA.|Western University, Los Angeles, CA, USA.
Lancer
L
Naghdechi
Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, Los Angeles, CA, USA.
Enrique
E
Lopez
Cedars-Sinai Medical Center, Division of General Internal Medicine, Los Angeles, CA, USA.
Teryl
T
Nuckols
D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D010351:Patient Discharge; D010361:Patients / Q000523:psychology