Depression, alcohol use disorders and nicotine dependence among patients at a general hospital

The prevalence of depression and anxiety among cardiovascular patients at University of Gondar specialized hospital using beck's depression inventory II and beck anxiety inventory: A cross-sectional study

Psychosocial issues are leading factor as well as consequences of cardiovascular disease. Identifying factors associated with depression facilitate service quality improvement for inpatients. This study assessed the prevalence and identified associated factors with depression and anxiety among patients with cardio vascular disease.

Method

An institution-based cross-sectional study was conducted with a convenience sample of 370 stable adult patients from June 1 to July 30, 2020 among cardiovascular disease patients at the University of Gondar Specialized Hospital Ethiopia. Data were collected by using structured questionnaires. Data analyses were conducted using SPSS version 21. The statistical significance declared at p-value <0.05.

Result

In this study, among 370 Cardiovascular diseases patients, 228 (61.6 %) suffer from anxiety, and 53.51 % (198) suffer with depression. There was a significant mean difference in the level of depression and anxiety between male and female Cardiovascular diseases patients. The females' scores of depression (mean = 28, p < 0.01) and anxiety (mean = 25.3, p < 0.01) were more than that of males 'scores of depression (mean = 15.1, p < 0.01) and anxiety (mean = 12.3, p < 0.01). Cardiovascular diseases patients aged greater than 60 years have the highest rate of prevalence of depression in all age group. Being in the age category of greater than 60 years was 1.16 (0.57-2.32) times more likely to have depression than the age category of 18-24 years. Depression and anxiety were significantly associated with being woman, widowed, being single, unable to read and write, and possess mental disorders history.

The Role of Sex and Gender in Dermatology - From Pathogenesis to Clinical Implications

BACKGROUND

Sex and gender have increasingly been recognized as significant risk factors for many diseases, including dermatological conditions. Historically, sex and gender have often been grouped together as a single risk factor in the scientific literature. However, both may have a distinct impact on disease incidence, prevalence, clinical presentation, severity, therapeutic response, and associated psychological distress.

OBJECTIVES AND PROJECT DESCRIPTION

The mechanisms that underlie differences in skin diseases between males, females, men, and women remain largely unknown. The specific objectives of this review paper are:To highlight the biological differences between males and females (sex), as well as the sociocultural differences between men and women (gender) and how they impact the integumentary system.To perform a literature review to identify important sex- and gender-related epidemiological and clinical differences for various skin conditions belonging to a range of disease categories and to discuss possible biological and sociocultural factors that could explain the observed differences.To discuss dermatological skin conditions and gender-affirming treatments within the transgender community, a population of individuals who have a gender identity which is different than the gender identity they were assigned at birth.

FUTURE IMPACT

With the rising number of individuals that identify as non-binary or transgender within our increasingly diverse communities, it is imperative to recognize gender identity, gender, and sex as distinct entities. By doing so, clinicians will be able to better risk-stratify their patients and select treatments that are most aligned with their values. To our knowledge, very few studies have separated sex and gender as two distinct risk factors within the dermatology literature. Our article also has the potential to help guide future prevention strategies that are patient-tailored rather than using a universal approach.

Prevalence and Associated Factors of Depression among Admitted Adult Patients in Surgical and Medical Wards of Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

BACKGROUND

Depression is a leading cause of major public health problems globally, and its prevalence has been increasing, particularly in low- and middle-income countries including our country. Therefore, this study is aimed at exploring depression symptoms and their determinants among admitted medical and surgical patients which is important to get optimal care for patients.

METHODS

An institution-based cross-sectional study was conducted from May to June 2019, on adults' medical and surgical admitted patients at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. The systematic random sampling technique was used to get a total of 590 samples. The standardized hospital anxiety and depression scale (HADS) was used to assess individual depression symptoms. We computed the bivariate and multivariate binary logistic regression analyses to identify factors associated with depression symptoms. Statistical significance was declared at P < 0.05.

RESULT

The prevalence of depression symptoms was found to be 53.9% (95% CI: 50.2, 57.0). In the multivariable logistic regression, female sex (AOR = 2.04, 95% CI: 1.35, 3.09), being single (AOR = 3.65, 95% CI: 3.48, 2.10, 5.78), widowed (AOR = 2.82, 95% CI: 1.27, 6.30), unable to read and write (AOR = 2.71, 95% CI: 1.14, 6.47), admission at medical ward (AOR = 1.59, 95% CI: 1.02, 2.46), history of mental illness (AOR = 1.59, 95% CI: 1.02, 2.46), and poor social support (AOR = 2.82, 95% CI: 1.57, 5.11) were factors significantly associated with depression symptoms.

CONCLUSION

The prevalence of depression symptoms among admitted patients was high. Female sex, being single, widowed, unable to read and write, admission at medical ward, history of mental illness, and poor social support were factors significantly associated with depression symptoms. It is better for the Ministry of Health to give training on how to screen depression among medical and surgical patients, and interventions that would be addressing the awareness of the above factors would be beneficial to prevent further complications.

Depression and Associated Factors among Adult Inpatients at Public Hospitals of Harari Regional State, Eastern Ethiopia

Introduction

Globally, depression is one of the three leading causes of disease and it will be the second leading cause of world disability by 2030. The prevalence of depression in Sub-Saharan Africa ranges from 15 to 30%. In Ethiopia, depression was found to be the seventh leading cause of disease burden and its prevalence has been increased in hospital compared to community setting because hospital environment itself is stressful. Yet, no study was done in Eastern Ethiopia, where substance use like Khat is very rampant.

Objective

To assess depression and associated factors among adult inpatients at public hospitals of Harari Regional State, Eastern Ethiopia, from February 01 to 28, 2017.

Methodology

Hospital based cross-sectional study design was employed on 492 admitted adult patients in Harari region hospitals. Consecutive sampling method was used to include study population. The data were collected by interviewee and analyzed by SPSS version 20.0. Bivariate and multivariate logistic regression analyses were employed. p value of 0.05 or less was considered to be statistically significant.

Result

A total of 489 patients were interviewed with response rate of 99.4%. Having duration of 1-2 weeks in the hospital [AOR = 2.02, 95% CI: (1.28, 3.19)], being diagnosed with chronic morbidity [AOR = 4.06, 95% CI: (2.23, 7.40)], being users of psychoactive drugs [AOR = 2.24, 95% CI: (1.18, 4.24)], and having been admitted to surgical ward [AOR = 0.50, 95% CI: (0.31, 0.81)] were significantly associated with depression.

Conclusion and Recommendation

Prevalence of depression among admitted inpatients was high. Therefore, increasing the awareness of benefits of early diagnosis of patients to prevent major form of depression and strengthening the clinical set-up and establishing good referral linkage with mental health institutions was considered to be cost-effective method to reduce its prevalence.

Conjoint moderate or high-risk alcohol and tobacco use among male out-patients in Thailand

Objective

To better understand conjoint alcohol and tobacco use among male hospital out-patients, the purposes of this study were: (1) to assess the prevalence of conjoint use and (2) to determine the factors associated with the conjoint alcohol use and tobacco use.

Methods

In a cross-sectional survey, consecutive male out-patients from four district hospitals in Nakhon Pathom province in Thailand were assessed with the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Hospital Anxiety and Depression Scale (HADS), self-reported chronic conditions and health-seeking behaviour. The sample included 2208 study participants, with a mean age of 36.2 years (SD = 11.7) and an age range of 18–60 years.

Results

Overall, 34.5% of the male hospital out-patients were conjoint moderate or high-risk alcohol and tobacco users, and 31.1% were moderate or high-risk alcohol or tobacco users. In multivariate analysis, younger age, having primary or less education, being separated, divorced or widowed, not having diabetes and not being obese were associated with conjoint moderate or high-risk alcohol and tobacco use.

Conclusion

High prevalence and several risk factors of conjoint alcohol and tobacco use were found among hospital male out-patients. The findings of this study call for dual-intervention approaches for both alcohol and tobacco.

Psychological Distress in the Hospital Setting: A Comparison between Native Dutch and Immigrant Patients

Background

Prevalence of psychological distress (i.e. depressive and anxiety symptoms) in medically ill patients is high. Research in the general population shows a higher prevalence of psychological distress among immigrants compared to natives. Our aim was to examine the prevalence of psychological distress in the hospital setting comparing immigrant and native Dutch patients and first and second generation immigrant patients.

Methods

Prevalence of psychological distress was assessed using the extended Kessler-10 (EK-10) in 904 patients in a Dutch general teaching hospital. Logistic regression was used to calculate odds ratios to determine differences between native and immigrant patients and first and second generation immigrants in the prevalence of psychological distress. We adjusted for demographic and social variables, socio-economic status, physical quality of life, history of psychiatric disease and health care use.

Results

Of 904 patients, 585 were native Dutch patients and 319 were immigrant patients. The prevalence of psychological distress in native compared to immigrant patients was 54% and 66% respectively, with especially high prevalences among Turkish and Moroccan immigrant patients. The crude OR for prevalence of psychological distress for immigrant patients versus native patients was 1.7 (95% CI 1.2–2.2) and for first versus second generation immigrant patients 2.1 (95% CI 1.2–3.5). After full adjustment ORs were 1.7 (95% CI 1.2–2.3) and 2.2 (95% CI 1.2–4.1) respectively.

Conclusion

Immigrant patients and first generation immigrant patients were more likely to have psychological distress compared to native patients and second generation immigrant patients respectively. We found a particularly high prevalence of psychological distress in Turkish and Moroccan immigrants.

Indicators of psychiatric disorders in different oncology specialties: a prevalence study

Objective. This study evaluated the prevalence of various indicators of psychiatric disorders in Brazilian outpatients with cancer and assessed possible associations with sociodemographic indicators. Materials and Methods. A total of 1,385 patients were evaluated using the following instruments: Patient Health Questionnaire-4 (PHQ-4), Generalized Anxiety Disorder (GAD-7), Fagerström Test for Nicotine Dependence (FTND), and Fast Alcohol Screening Test (FAST). Results. The sample was composed of both genders with a slight predominance of women (55.8%), subjects with incomplete/completed elementary school (59%), married (67.4%), with children (94%), not active from a labor viewpoint (61.6%), and following some type of religion (79.5%). The prevalence of anxiety for the total sample varied between 21.5 and 27.4%. The prevalence of depression was 21.1%, tobacco abuse/dependence was 40.2%, and alcohol was 20.3%. Women had significantly higher levels of anxiety and depression than men. Men had higher levels of substance abuse/dependence indicators than women. Conclusion. These results are consistent with the literature, which attests to the high prevalence of psychiatric disorder indicators in cancer patients, especially compared to the general population.

Are two items sufficient to screen for depression within the hospital context?

OBJECTIVE

to determine the ability of the reduced form of a screening instrument, the Patient Health Questionnaire-2 (PHQ-2), to assess the presence of depressive disorders in patients admitted to a general hospital.

METHOD

A sample of 227 patients admitted to the clinical wards of a Brazilian general university hospital were assessed with Module A of the Diagnostic Structured Interview for the DSM-IV (SCID-IV) and filled out the PHQ-9 and PHQ-2.

RESULTS

The PHQ-2 demonstrated an area under the ROC curve of 0.89 (p < 0.0001), with a cutoff point of three or more being the one that best equilibrated the sensitivity (0.86) and specificity (0.75) values. The agreement index between the PHQ-2 and module A of SCID-IV was 78.4% and the Kappa value was 0.51. Regarding reliability, the Cronbach alpha value obtained was 0.64 and the intraclass correlation coefficient was 0.52.

CONCLUSION

PHQ-2 proved to be an instrument with good psychometric properties comparable to those of PHQ-9, being superior to the latter regarding the rate of false-positive results. In addition, it is a brief instrument that elicits little resistance on the part of the patient, being inexpensive and requiring little time, thus being of important help to the treatment teams for the detection of depressive disorder, being suitable for incorporation into hospital admission protocols and thus possibly favoring more immediate interventions.

Screening for smoking in a general hospital: scale validation, indicators of prevalence, and comorbidity

PURPOSE

The study aims to conduct a psychometric study of the Fagerström Test for Nicotine Dependence (FTND) and to assess the prevalence, sociodemographic profile, and psychiatric comorbidities of smokers in a general hospital.

DESIGN AND METHODS

Two hundred sixty-four inpatients were elegible for inclusion in the study and assessed with Structured Clinical Interview for the DSM-IV (Module E), Patient Health Questionnaire, Fast Alcohol Screening Test, and FTND.

FINDINGS

The cut-off note two of the FTND is the most adequate to identify tobacco abuse/dependence (sensibility: 0.59-0.76). The reliability was estimated to be 0.68-0.96. A 44% rate of tobacco abuser/dependent patients was detected, with a 28% rate of psychiatric comorbidity.

PRACTICE IMPLICATIONS

Detection of the smoking habits at the time of hospitalization can be opportune, favoring the planning and the beginning of treatment.

The Brazilian smoker: a survey in the largest cities of Brazil

OBJECTIVE

To understand the sociodemographic factors associated with daily consumption of cigarettes and pattern of cigarette use among Brazilian smokers.

METHOD

A cross-sectional study was performed in 2005 involving the 108 largest Brazilian cities. Data were collected through interviews with subjects aged 12 to 65 years in randomly selected households. Based on a questionnaire adapted to the Brazilian context, a logistic regression model was used to investigate the association between the sociodemographic characteristics of the sample and smoking.

RESULTS

Of the 7,921 subjects interviewed, 16.4% reported daily use of cigarettes. The smoking prevalence was similar between genders, although women reported to start smoking at a later age and smoke fewer cigarettes per day. Almost 65% of the smokers were interested in quitting or reducing their smoking habit. The main sociodemographic characteristics associated with smoking were as follows: adult age (30-59 years old), unemployment, low education level, and low socioeconomic level. Alcohol abuse was also shown to be associated with smoking.

CONCLUSIONS

Our findings suggest that adverse socioeconomic characteristics are implicated in increased susceptibility to smoking in Brazil. In our sample, a high proportion of smokers reported interest to quit or reduce smoking. These data suggest that sociodemographic factors should be considered in the elaboration of smoking prevention and treatment policies.

Difference between the prevalence of symptoms of depression and anxiety in non-diabetic smokers and in patients with type 2 diabetes with and without nicotine dependence

BACKGROUND

Individuals with diabetes who are smokers have higher risks of cardiovascular disease, premature death, and microvascular complications. The present study aims to determine the prevalence of symptoms of depression and anxiety in smokers with type 2 diabetes mellitus (T2D) and to evaluate if the prevalence of symptoms of depression and anxiety differ between the three groups studied (patients with T2D who smoke; patients with T2D who do not smoke; smokers without T2D), and finally determine if the degree of nicotine dependence is related to symptoms of anxiety and depression in smokers (with or without T2D).

METHODS

Three study groups were formed: 46 T2D smokers (DS), 46 T2D non-smokers (D), and 46 smokers without diabetes (S), totaling 138 participants. Hospital Anxiety and Depression (HAD) scale and Fagerström Test were applied.

RESULTS

The prevalence of symptoms of depression and anxiety in smokers with T2D was 30.4% and 50%, respectively. There was no significant difference in the proportion of individuals with symptoms of anxiety (p = 0.072) or depression (p = 0.657) in the DS group compared to group D or S. Among male patients with T2D, the smokers had a higher prevalence of anxiety symptoms (19.6%) than non-smokers (4,3%) (p = 0,025). The prevalence of high nicotine dependence among smokers with and without T2D was 39.1% and 37.1%, respectively (p = 0.999). Fagerström scores showed no significant correlation with the scores obtained on the subscale of anxiety (p = 0,735) or depression (p = 0,364).

CONCLUSIONS

The prevalence of depression and anxiety among smokers with and without diabetes and non-smokers T2D is similar. Among male individuals with T2D, the smokers have more symptoms of anxiety than the non-smokers. There is no difference in the prevalence of nicotine dependence among smokers with and without diabetes. The presence of symptoms of anxiety or depression is similar between patients who are dependent and not dependent on nicotine.

Depressive symptoms among hospitalized patients in Israel

Depressive symptoms are common among hospitalized patients and can indicate more serious problems. This study examined the level of depressive symptoms among patients in one hospital in Jerusalem, the variables related to depression, and the extent to which social workers provided services to those patients. Over 60% of patients reported high levels of depressive symptoms. Levels were higher among Arabs, those with lower income, small social networks, stronger locus of control (powerful others), weaker internal locus of control, and low emotional support from staff. Social workers were in contact with 44% of patients who had high levels of depressive symptoms.

Tentativa de suicídio entre pacientes com uso nocivo de bebidas alcoólicas internados em hospital geral

OBJETIVO: Detectar fatores associados a histórico de tentativa de suicídio (TS) em pacientes internados em hospital geral que fazem uso nocivo de bebidas alcoólicas. MÉTODO: 4.352 pacientes admitidos consecutivamente foram avaliados utilizando-se um rastreamento do qual constavam as escalas AUDIT (Alcohol Use Disorder Identification Test) e HAD (Escala Hospitalar de Ansiedade e Depressão). Fixando-se histórico de tentativa de suicídio ao longo da vida como variável dependente, foram realizados testes do qui-quadrado e regressão logística múltipla. RESULTADOS: Uso nocivo de álcool (AUDIT > 8) foi detectado em 423 pacientes. Dentre eles, 60 (14,2%) apresentavam sintomas de depressão (HAD > 8) e 34 (8%) tinham histórico de TS. Este se associou a ser adulto jovem [razão de chance (RC) = 3,4], depressão (RC = 6,6), uso pregresso de psicofármaco (RC = 7) e ter SIDA (RC = 24). CONCLUSÃO: Os resultados fortalecem a necessidade de detectar e tratar adequadamente condições que, combinadas, aumentam consideravelmente o risco de suicídio.