Unrecognized depression in hospitalized medicine patients

Abstract

Depressive disorders are prevalent among hospitalized medicine patients with other medical conditions, though adequate clinical attention may not be given to this comorbid condition. Many physicians feel that this is something that is best addressed in the outpatient setting; however, depression may have important implications in the management of the hospitalized patient. While other hospitalized populations have been studied, such as those with CHF, ESRD, or cancer, there is minimal data regarding depression in hospitalized general internal medicine patients. We estimate that depression among this population is much more prevalent than currently realized. Many screening tools for depression exist, though no tool is considered the gold standard. The DMI-18 screening questionnaire has been formulated to be especially useful in the medically ill. It attempts to minimize somatic symptoms of depression by focusing on the cognitive symptoms. This is important, because many ill patients have somatic symptoms due to their disease that can mask or blur the distinction between depression and other physiologic illness.