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      Prevalencia de trastornos psiquiátricos en pacientes medicoquirúrgicos hospitalizados en la Clínica Universitaria Bolivariana de Medellín, Colombia Translated title: Prevalence of psychiatric disorders in medical-surgical hospitalized patients in the Clinica Universitaria Bolivariana from Medellín, Colombia

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          Abstract

          INTRODUCCIÓN: La literatura informa una prevalencia alta de trastornos psiquiátricos en personas hospitalizadas con enfermedades médicas. OBJETIVO: El grupo de psiquiatría de enlace se propuso determinar la frecuencia de trastornos psiquiátricos en los pacientes hospitalizados en los servicios de medicina interna, cirugía, ginecología y ortopedia de la Clínica Universitaria Bolivariana de Medellín. METODOLOGÍA: Estudio descriptivo de 157 personas entrevistadas aleatoriamente en un período de 30 días. Se diseñó un formulario con preguntas que incluían aspectos sociodemográficos y clínicos que se aplicó a cada uno de los entrevistados. Se realizó el Mini-Examen Cognoscitivo (MEC 35) a todos los pacientes. Si el MEC 35 no encontraba alteración psiquiátrica se aplicaba la Escala de Ansiedad y Depresión Hospitalaria (EADH). A quienes tuvieron alteraciones en el MEC 35 o en la EADH, se les realizó una entrevista clínica para diagnosticar el trastorno psiquiátrico presente. RESULTADOS: Del total de pacientes, 70 (44.5%), se diagnosticaron con algún trastorno psiquiátrico. El más frecuente fue demencia en 19 (12.1%), seguido por trastorno depresivo mayor, 16 (10.2%). CONCLUSIONES: Existe una frecuencia de 44.5% de trastornos psiquiátricos en los pacientes hospitalizados de la Clínica Universitaria Bolivariana, Medellín que no son diagnosticados por el personal médico no psiquiatra. Se sugiere realizar jornadas de actualización médica en psiquiatría para el personal médico y paramédico de la institución y crear líneas de investigación en psiquiatría de enlace en otros centros médicos de Medellín.

          Translated abstract

          INTRODUCTION: There is a high prevalence of psychiatric disorders among hospitalized patients reported in medical literature. OBJECTIVE: The consultation-liaison psychiatry group had the purpose of determinate the frequency of psychiatric disorders in hospitalized patients in the internal medicine, surgery, gynecology and orthopedics services in the Clínica Universitaria Bolivariana. METHODS: We present a descriptive observational study of 157 patients randomly interviewed over a 30 day period. A form was designed with questions including sociodemographic and clinical aspects and it was applied to all the interviewed ones. We administered the Mini-Mental State Examination (MMSE 35) to all the patients. If it did not detect any psychiatric disorder then a Hospital Anxiety and Depression Scale (HADS) was applied. Those with alterations in the MMSE 35 or the HADS had a clinical interview made in order to diagnose the existing psychiatric disorder. RESULTS: 70 (44.5%) patients were diagnosed with some psychiatric disorder. The most frequent being dementia n= 19 (12.1 %) followed by depressive disorder n= 16 (10.2 %). CONCLUSIONS: There is a high frequency of psychiatric disorders in hospitalized patients of Clínica Universitaria Bolivariana (44.5%) that are not diagnosed by non- psychiatrist medical staff. We suggest to plan actualization journeys on psychiatry for the medical and paramedical staff of this institution and also to create research lines on liaison psychiatry in other medical centers in Medellín city.

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          Most cited references61

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          International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results.

          More than 200 published studies from most medical settings worldwide have reported experiences with the Hospital Anxiety and Depression Scale (HADS) which was specifically developed by Zigmond and Snaith for use with physically ill patients. Although introduced in 1983, there is still no comprehensive documentation of its psychometric properties. The present review summarizes available data on reliability and validity and gives an overview of clinical studies conducted with this instrument and their most important findings. The HADS gives clinically meaningful results as a psychological screening tool, in clinical group comparisons and in correlational studies with several aspects of disease and quality of life. It is sensitive to changes both during the course of diseases and in response to psychotherapeutic and psychopharmacological intervention. Finally, HADS scores predict psychosocial and possibly also physical outcome.
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            International experiences with the Hospital Anxiety and Depression Scale-A review of validation data and clinical results

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              Hospital Anxiety and Depression Scale (HAD): some psychometric data for a Swedish sample.

              The Hospital Anxiety and Depression Scale (HAD) was evaluated in a Swedish population sample. The purpose of the study was to compare the HAD with the Beck Depression Inventory (BDI) and Spielberger's State Trait Anxiety Inventory (STAI). A secondary aim was to examine the factor structure of the HAD. The results indicated that the factor structure was quite strong, consistently showing two factors in the whole sample as well as in different subsamples. The correlations between the total HAD scale and BDI and STAI, respectively, were stronger than those obtained using the different subscales of the HAD (the anxiety and depression subscales). As expected, there was also a stronger correlation between the HAD and the non-physical items of the BDI. It was somewhat surprising that the factor analyses were consistently extracting two factors, 'depression' and 'anxiety', while on the other hand both BDI and STAI tended to correlate more strongly with the total HAD score than with the specific depression and anxiety HAD subscales. Nevertheless, the HAD appeared to be (as was indeed originally intended) a useful clinical indicator of the possibility of depression and clinical anxiety.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                cm
                Colombia Médica
                Colomb. Med.
                Facultad de Salud, Universidad del Valle, Cali, Colombia (Cali )
                1657-9534
                September 2005
                : 36
                : 3
                : 186-193
                Affiliations
                [1 ] Universidad Pontificia Bolivariana Colombia
                Article
                S1657-95342005000300009
                47056416-6a90-4168-9bfe-9f6af61202f8

                http://creativecommons.org/licenses/by/4.0/

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                Product

                SciELO Colombia

                Self URI (journal page): http://www.scielo.org.co/scielo.php?script=sci_serial&pid=1657-9534&lng=en
                Categories
                MEDICINE, GENERAL & INTERNAL

                Internal medicine
                Dementia,Depression,Delirium,Prevalence,Liaison psychiatry,Hospitalized patient,Psychiatric treatment,Psychosomatic,Demencia,Depresión,Delirio,Prevalencia,Psiquiatría de enlace,Paciente hospitalizado,Tratamiento psiquiátrico,Psicosomática

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