Screening for depression and suicidality in patients with cardiovascular illnesses.
Screening for depression and suicidality in patients with cardiovascular illnesses.
复制标题
筛查心血管疾病患者的抑郁症和自杀倾向。
DOI:
10.1016/j.amjcard.2009.06.033
复制
发表时间:
2009
期刊:
影响因子:
--
通讯作者:
Yehuda,Rachel
中科院分区:
文献类型:
--
作者:
Shemesh,Eyal;Annunziato,RachelA;Rubinstein,David;Sultan,Sarah;Malhotra,Jotinder;Santra,Mugdha;Weatherley,BethD;Feaganes,JohnR;Cotter,Gad;Yehuda,Rachel
The American Heart Association (AHA) and the American Psychiatric Association jointly recommend screening for depression in cardiology clinics. This includes screening for suicidality. It is not known how frequently patients disclose suicidal thinking (ideation) in this setting, and what proportion of those will turn out to have suicidal intent. Patients were screened for depression using a protocol identical to the one endorsed by the AHA in a cardiology community clinic in Elmhurst (Queens, New York). Depression was assessed using the Patient Health Questionnaire. Reports of suicidal ideation were immediately evaluated by a mental health professional. We determined the degree to which suicidal ideation was identified, the proportion of patients with suicidal intent of those reporting suicidal ideation, and the relation between depression and suicidal ideation in this setting. One thousand three patients were screened; 886 had complete Patient Health Questionnaire data. Of those, 12% (109 patients) expressed suicidal ideation. Four of those were hospitalized for suicidal intent (0.45% of all screened patients). Suicidal ideation and depression were correlated (point biserial correlation coefficient 0.478). In conclusion, suicidal ideation can and will be identified using the AHA depression screening recommendations, but only a very small fraction (0.45%) of screened patients will turn out to have suicidal intent. Discovery and stabilization of suicidal patients is an important benefit of the screening, but the fact that >12% of all screened patients will need to be immediately evaluated for suicidal intent has important implications for resource allocation to screening programs.