Recognition of depression in older medical inpatients.
Recognition of depression in older medical inpatients.
复制标题
识别较旧的医疗住院患者抑郁症。
DOI：
10.1007/s11606-006-0085-0
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发表时间：
2007-05
影响因子：
5.7
通讯作者：
Ciampi, Antonio
中科院分区：
文献类型：
--
作者：
Cepoiu, Monica;McCusker, Jane;Cole, Martin G.;Sewitch, Maida;Ciampi, Antonio
对老年（65岁或以上）住院患者抑郁症的识别研究表明，主治医生对抑郁症的识别率较低。然而，很少有研究比较不同的措施识别抑郁症。(1)比较抑郁症识别的四个指标和一个整体的识别对抑郁症诊断的有效性和（2）探讨患者的特征对抑郁症的识别的影响。在264名65岁及以上的内科住院患者（115名患有重度或轻度抑郁症，78名无抑郁症）中，计算了4项识别指标（症状，诊断，治疗和转诊）和整体识别指标（4项指标中的任何一项）的敏感性，特异性和诊断比值比（DOR）。患者特征（年龄、性别、抑郁症史、入院前抗抑郁药使用、抑郁症严重程度、合并症、住院时间、残疾和入院医院）与识别之间的关系采用多元Logistic回归进行了探讨。只有不到一半的抑郁症患者被发现。敏感性最高的指标是治疗（27.8%，95%置信区间[CI] 20.0-37.0），而特异性最好的指标是诊断（96.6%，95% CI 91.9-98.7）。整体识别的未调整DOR为2.6（95% CI 1.5，4.4）。较少的合并症、较严重的抑郁症状、抑郁病史、较长的住院时间和入院前使用抗抑郁药与更好的整体认知度显著相关。老年内科住院患者抑郁症的识别取决于识别的指标。
Studies of recognition of depression in older (aged 65 or more) medical inpatients show low rates of recognition of depression by attending physicians. However, few studies have compared different measures of recognition of depression. (1) To compare the validity of four indicators of recognition of depression and a global measure of recognition against a diagnosis of depression and (2) to explore the effect of patient characteristics on recognition of depression. In a cohort of 264 medical inpatients 65 years and older (115 with major or minor depression, 78 with no depression), sensitivities, specificities, and diagnostic odds ratios (DOR) of 4 indicators of recognition (symptoms, diagnosis, treatment, and referral) and a global measure of recognition (any of the 4 indicators) were calculated. The associations between patient characteristics (age, sex, history of depression, antidepressant use before admission, severity of depression, comorbidity, duration of hospitalization, disability, and hospital of admission) and recognition were explored using multiple logistic regression. Less than half of the depressed patients were recognized. The indicator with the highest sensitivity was treatment (27.8%, 95% confidence interval [CI] 20.0–37.0), whereas the indicator with the best specificity was diagnosis (96.6%, 95% CI 91.9–98.7). The unadjusted DOR of global recognition was 2.6 (95% CI 1.5, 4.4). Less comorbidity, more severe depression symptoms, a history of depression, longer hospital stay, and antidepressant use before admission were significantly associated with better global recognition. Recognition of depression in elderly medical inpatients depends upon the indicator of recognition used.
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影响因子：
6.9
作者：
HENDERSON, AS;JORM, AF;DOYLE, C
通讯作者：
DOYLE, C
影响因子：
2.8
作者：
Lichtenberg, Peter A.;Gibbons, T. Ann;Blumenthal, Frank
通讯作者：
Blumenthal, Frank
影响因子：
120.7
作者：
JOHNSON, J;WEISSMAN, MM;KLERMAN, GL
通讯作者：
KLERMAN, GL
DOI：
10.1111/j.1532-5415.2005.53404.x
发表时间：
2005-08-01
影响因子：
6.3
作者：
McCusker, J;Cole, M;Elie, M
通讯作者：
Elie, M
影响因子：
6.2
作者：
Meldon, SW;Emerman, CL;Etheart, RG
通讯作者：
Etheart, RG