Department of Medical Psychology and Psychiatry, UNICAMP, Campinas, SP, Brazil.
Braz J Psychiatry. 2010 Sep;32(3):250-6. doi: 10.1590/s1516-44462010005000016. Epub 2010 Jul 2.
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.
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.
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).
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.
确定在一所综合教学医院住院的个体中抑郁、酒精使用障碍和尼古丁依赖的患病率，并确定与这些障碍相关的患者特征。
使用医院焦虑抑郁量表和酒精使用障碍识别测试，我们评估了在 13 个月期间连续收治的 4352 例内科和外科患者。还要求患者报告过去一个月内的每日吸烟习惯。进行了多变量逻辑回归分析，并计算了比值比（OR）。
样本的平均年龄为 49.3 岁，56.6%为男性。抑郁、酒精使用障碍和尼古丁依赖的患病率分别为 14%、9.8%和 16.9%。在多变量分析中，抑郁与既往自杀企图（OR=8.7）、较低的教育水平（OR=3.6）、先前使用精神药物（OR=3.1）、癌症（OR=1.7）和疼痛（OR=1.7）相关。酒精使用障碍与男性（OR=6.3）、吸烟（OR=3.5）、因外部伤害入院，如交通事故（OR=2.4）和既往自杀企图（OR=2.3）相关。尼古丁依赖与酒精使用障碍（OR=3.4）、青年期（OR=2.3）、丧偶（OR=2.2）和既往自杀企图（OR=1.8）相关。
这是巴西一家综合医院使用标准化筛查工具对最大的内科和外科患者样本进行的调查。精神障碍的高患病率以及本研究中评估的患者特征突出表明，需要开发更有效的方法来检测和管理这些障碍。住院应被视为检测精神障碍的主要机会，并随后实施适当的特定治疗策略。
