Screening for depression in post stroke patients.
Screening for depression in post stroke patients.
复制标题
筛查中风后患者的抑郁症。
作者：
S. U. Haq;C. Symeon;M. Agius;R. Brady
背景
抑郁症在中风后的患者中具有显著的流行性。研究发现，这一比例在25- 54%之间。
旨在
在这次审计中，我们的目的是确定已被确定为患有抑郁症的患者的比例，并探索用于识别抑郁症患者的方法。我们还评估了这些接受抑郁症治疗的患者的数量，并探索了用于治疗抑郁症的药物。
方法
审计工作分两个阶段进行。最初进行审计，以确定目前的患病率，筛选和中风后患者的抑郁症的管理。在此之后，我们引入了PHQ-9作为抑郁症的筛查工具，并在四个月后重新审核。在第2阶段，2009年10月9日至2009年12月13日期间在贝德福德医院斯托克病房住院的所有患者均纳入稽查。入院后两周，使用PHQ-9问卷对患者进行抑郁症筛查。
结果
第一阶段组的抑郁症发生率为28%。其中9例病例的病历中没有情绪评估或抑郁症诊断的记录。60名病人中有13名在住院期间被处方精神药物。在第2阶段，在筛选的18名患者中，10名患者（56%）评分为5分或以上，根据PHQ-9的评分系统，这指示抑郁。一名患者得分为10，表明中度抑郁，一名患者得分为19，表明中度重度抑郁。
讨论
第一阶段的审查显示，目前还没有正式的筛查工具来识别中风后患者的抑郁症。因此，我们发现患病率为28%。根据文献，这与该组内预期发生率的下限相关。由于没有使用筛选工具，因此做法不符合NICE指南规定的标准。这促使我们在第二阶段引入PHQ-9筛查工具。在此之后，我们发现抑郁症的患病率从28%上升到56%。
结论
这些结果强调了正式筛查的重要性，以便可靠地识别有抑郁症迹象的患者。
BACKGROUND
depression has a significant prevalence in patients following a stroke. Studies have found rates to be between 25-54%.
AIMS
Within this audit we aimed to ascertain the proportion of patients who have been identified as having depression, and explore the methods employed to identify depressed patients. We also looked to assess the number of these patients who have been treated for depression and to explore the medications used for the treatment of depression.
METHODS
this audit was conducted in two phases. Initially an audit was conducted to establish the current prevalence, screening and management of depression in post-stroke patients. Following this, we introduced the PHQ-9 as a screening tool for depression and a re-audited at four months. In phase 2, All patients admitted to the stoke ward in Bedford hospital between 10/9/09 and 13/12/09 were included in the audit. Patients were screened for depression using the PHQ-9 questionnaire two weeks after admission.
RESULTS
the incidence of depression within the phase one group was 28%. In 9 of these cases there was no record of mood assessment or diagnosis of depression in the medical notes. Thirteen out of 60 patients were prescribed psychotropic agents during their stay. In phase 2, Of the 18 patients screened, 10 patients (56%) scored 5 or above, which according to the scoring system of the PHQ-9 is indicative of depression. One patient scored 10 indicative of moderate depression and one patient scored 19 indicative of moderately severe depression.
DISCUSSION
phase 1 of this audit revealed that there was no formal screening tool in use to identify depression in post stroke patients. Consequently we found the prevalence to be 28%. This correlates with the lower end of the rate expected within this group according to the literature. As no screening tool was being used, practice was not in accordance with the standards set by NICE guidelines. This led us to introduce the PHQ-9 screening tool in phase 2. Following this, we found the prevalence of depression had increased from 28% to 56%.
CONCLUSIONS
these results highlight the importance of formal screening in order to reliably identify patients who have signs of depression.