Depression, Anxiety and Alcohol Abuse in a Gastroenterology Intensive Care Unit: Prevalence and Detection

Abstract

Abstract:Objectives: To assess depression, anxiety, and alcohol abuse in a Gastroenterology ICU, and the level of its detection by the staff.Method: All patients consecutively admitted to the ICU during a six-month period, 18 or above, and staying 24 hours, were assessed with the Hospital Anxiety and Depression Scale (HADS) and the CAGE. Doctors and nurses assessed the type and severity of patients' morbidity. Data were analyzed with Student's t-test, Pearson's and Spearman's correlations for ordinal variables, chi-square for nominal variables, and multiple logistic regression.Results: The 65 patients assessed had a mean age of 57, and were predominantly male (58.5%), married (72.3%), and retired (53.8%); 27.7% had a psychiatric history, 24.6% were on psychotropic drugs, and 32.3% had an alcohol intake above standards. Anxiety and depression HADS scores 8 were present in 29.2% and 35.4% of the patients, respectively; 20%, mainly men, scored positive on the CAGE. Women had significantly higher anxiety scores (=.012) than men but did not differ in depression. A psychiatric history was significantly associated with higher anxiety (p<.001) and depression (p=.007) scores, as well as being on psychotropic drugs regularly (p<.001; p=.03, respectively).Doctors diagnosed somatic illness in 48.8%, and somatic illness with psychiatric co-morbidity in 51%; for nurses the rates were, respectively, 41.5% and 58.6%. Doctors' and nurses' detection of psychiatric disorders were significantly associated with the HADS anxiety scores (p=.013; p=.001, respectively), and doctor's detection with depression (p=.046) scores. There were no significant associations between nurses' detection of psychiatric disorders and depression, and between both professional groups detection and alcohol abuse.Conclusion: High prevalence of depression, anxiety, and alcohol abuse in Gastroenterology ICU was confirmed. However, the level of detection by the staff was low and mainly when anxiety symptoms were present.

Health professionals’ detection of depression and anxiety in their patients with diabetes: The influence of patient, illness and psychological factors

“…As expected, depression and anxiety were found to be highly comorbid, with 76 per cent of participants who were identified as depressed reporting clinically significant levels of anxiety. Consistent with previous research across a number of medical settings (Cardoso et al, 2010;Janssen et al, 2012;Thompson et al, 2001), we report better recognition of depression and anxiety with increased severity of depressive and anxious symptoms. Furthermore, participants who reported clinically significant levels of both depression and anxiety were more likely to be identified as experiencing emotional problems, a finding also reported by Janssen et al (2012) among family care doctors.…”

“…Older adults are also more likely to misattribute symptoms of depression to medical illness or normal ageing (Gallo et al, 1994) and tend to report more physical and cognitive symptoms of depression, rather than affective symptoms such as low mood (Gallo and Rabins, 1999). Research investigating doctors’ and nurses’ detection of psychological conditions (depression, anxiety, delirium and psychosis) in a gastroenterology intensive care unit found detection was significantly associated with severity of patient anxiety symptoms (Cardoso et al, 2010). Family doctors’ recognition of depression and anxiety appears better among patients with increased severity, comorbid anxiety and depressive disorders, and older age (Janssen et al, 2012).…”