Diagnosis and pharmacological treatment of depressive disorders in a general hospital

Abstract

Objective: To determine the point prevalence of depressive disorders in medical inpatients, to identify related sociodemographic and medical factors and to evaluate the psychotropic treatment given.

Method: A cross-sectional study identifying the prevalence of depressive disorders and related factors combined with a prospective longitudinal study evaluating the psychopharmacological treatment were conducted. Medical inpatients, aged 18 years or older, presenting suitability to be interviewed and giving written informed consent were selected. The sample was composed of 125 subjects. The following instruments were used: a sociodemographic questionnaire; the Mini International Neuropsychiatric Interview; and the Beck Depression Inventory. Data related to medical, personal and family histories of psychiatric disorders and psychotropic use were collected by interview and from patient charts. The study took place at the Hospital Santa Isabel, in Blumenau, located in the state of Santa Catarina, Brazil, from January to July of 2002.

Results: The prevalence of depressive disorders was 26%. The factors that correlated with depressive disorders were being female, having an income lower than 3 times the minimum wage, having a personal history of depressive disorders, using psychotropic drugs, scoring higher than 13 on the Beck Depression Inventory and having been referred for a psychiatric consultation (p < 0.05). Only 43.8% of the individuals with depressive disorders received antidepressants. Most of the depressed patients were being treated with benzodiazepines (62.5%). The most frequently prescribed drugs were diazepam and fluoxetine.

Conclusions: Approximately one-quarter of the medical inpatients had depressive disorders. However, antidepressants were prescribed for less than half of them. Women with a history of depression, using benzodiazepines and having a low income presented significantly higher rates of depressive disorders. Physicians should suspect depression in patients presenting such characteristics.