Central and North West London NHS Foundation Trust, London, UK.
Royal College of Psychiatrists, London, UK.
Clin Med (Lond). 2019 Mar;19(2):114-118. doi: 10.7861/clinmedicine.19-2-114.
Levels of awareness and treatment of depression in older adults admitted to acute hospitals are unclear. This study aims to examine the proportion of older adults diagnosed with depression in acute hospitals, treatment, referral, and communication between secondary and primary healthcare services following discharge. Retrospective examination of records of 766 older adults admitted to 27 acute hospitals in England was carried out. Ninety-eight (12.7%, 95% confidence interval (CI) = 10.6-15.3) records included a diagnosis of depression of which eight (1.0%, 95% CI = 0.5-2.0) had a new diagnosis made during their hospital admission. All newly diagnosed and 76 (84.4%, 95% CI = 75.5-90.5) of those with an existing diagnosis of depression were prescribed antidepressant medication. Six (75.0%, 95% CI = 40.9-92.8) of those with a new diagnosis, and 21 (23.3%, 95% CI = 15.8-33.0) with an existing diagnosis of depression were referred to liaison psychiatry. References to mental health were made in 50 (51.0%, 95% CI = 41.2-60.6) discharge letters sent to primary care. Very few older adults admitted to acute hospitals in this study were diagnosed with depression during their inpatient stay. Opportunities for improving the mental and physical health of such patients appear to be being missed.
在急症医院住院的老年人中，对其抑郁程度的认知和治疗情况尚不清楚。本研究旨在调查在英格兰 27 家急症医院住院的 766 名老年人中，被诊断为抑郁症的比例、治疗方法、转介情况以及出院后二级和初级保健服务之间的沟通情况。对 766 名老年人的记录进行了回顾性检查，这些人被收入 27 家急症医院。其中 98 份（12.7%，95%置信区间（CI）=10.6-15.3）记录包括抑郁症的诊断，其中 8 份（1.0%，95%CI=0.5-2.0）在住院期间新确诊。所有新诊断的患者和 76 名（84.4%，95%CI=75.5-90.5）有既往诊断的患者都被开具了抗抑郁药物。新诊断的患者中有 6 人（75.0%，95%CI=40.9-92.8），既往诊断的患者中有 21 人（23.3%，95%CI=15.8-33.0）被转介到联络精神病学。在发给初级保健的 50 份（51.0%，95%CI=41.2-60.6）出院记录中，提到了心理健康问题。在本研究中，住院的老年人中只有极少数被诊断为抑郁症。似乎错过了改善此类患者身心健康的机会。
