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Objective: To determine prevalence rates and identify patient characteristics associated with depression, alcohol use disorders and nicotine dependence among individuals admitted to a general teaching hospital. Method: Using the Hospital Anxiety and Depression Scale and Alcohol Use Disorder Identification Test, we assessed 4,352 consecutive medical and surgical patients admitted over a 13-month period. The patients were also asked to report their daily cigarette smoking habits during the last month. Multiple logistic regression analyses were performed, and odds ratios (ORs) were calculated. Results: The mean age of the sample was 49.3 years, and 56.6% were male. Prevalence rates of depression, alcohol use disorders and nicotine dependence were, respectively, 14%, 9.8% and 16.9%. In the multivariate analysis, depression was associated with previous suicide attempts (OR = 8.7), lower level of education (OR = 3.6), prior use of psychotropic medications (OR = 3.1), cancer (OR = 1.7) and pain (OR = 1.7). Alcohol use disorders were associated with male sex (OR = 6.3), smoking (OR = 3.5), admission for an external cause of injury, such as a traffic accident (OR = 2.4), and previous suicide attempts (OR = 2.3). Nicotine dependence was associated with alcohol use disorders (OR = 3.4), young adulthood (OR = 2.3), widowhood (OR = 2.2) and previous suicide attempts (OR = 1.8). Conclusion: This is the largest sample of medical and surgical patients ever surveyed with standardized screening instruments in a general hospital in Brazil. The high prevalence rates of psychiatric disorders and the profiles of the patients evaluated in this study underscore the need to develop methods that are more effective for detecting and managing such disorders. Hospital admission should be considered a major opportunity for the detection of psychiatric disorders and the subsequent implementation of the appropriate specific treatment strategies. Descriptors

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Objectives: To identify prevalence rates and related patient characteristics associated with depression, alcohol use disorders (AUD), and nicotine dependence among individuals admitted to a university general hospital. Methods: 4352 consecutively admitted patients were assessed using the HAD scale and AUDIT. They were also asked on daily cigarette smoking during the previous month. Multivariate logistic regression analyses were performed. Results: 56.6% were male. The average age was 49.3. Prevalence rates of depressive disorder, AUD and nicotine dependence were, respectively, 14%, 9.8% and 16.9%. In the multivariate analysis depression was associated with previous suicide attempt (OR = 8.7), less schooling (3.6), prior use of psychotropic medicines (3.1), cancer (1.7) and pain (1.7). AUD were associated with male sex (OR = 6.3), smoking (3.5), admission for an external cause (2.4), mainly road accidents, and previous suicide attempt (2.3). Nicotine dependence was associated with AUD (OR = 3.4), young adulthood (2.3), widowhood (2.2) and previous suicide attempt (1.8). Conclusions: This is the largest sample of medical and surgical inpatients surveyed by standardized screening instrument, for 13 months, in a Brazilian general hospital. High prevalence rates of psychiatric disorders and respective patient profiles highlight the need to develop more effective methods for detecting and managing these disorders. Hospital admission should be considered a milestone in a person's life from which a psychiatric disorder is detected and specific treatment strategies are implemented.

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