Identification of depression by medical and surgical general hospital physicians

Balestrieri, Matteo; Bisoffi, Giulia; Tansella, Michele; Martucci, M.; Goldberg, David

doi:10.1016/s0163-8343(01)00176-1

Cited by 43 publications

(37 citation statements)

References 35 publications

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“…We included 36 studies in our systematic review (Tables 1, 2, 3, and 4) Twenty-three papers reported only sensitivity [72][73][74][78][79][80][86][87][88][89][90][91][92][93][94][95][96][97][98][99][100][101][102] . For 10 of these studies, we calculated the specificity and the diagnostic OR.…”

Section: Resultsmentioning

confidence: 99%

“…For 10 of these studies, we calculated the specificity and the diagnostic OR. 72,73,80,87,89,91,93,[99][100][101] In 8 papers, both the sensitivity and specificity of recognition were presented. 75,77,[103][104][105][106][107][108] Eleven papers reported other measures (such as positive predictive value, agreement expressed as percentage or kappa correlation coefficient, and identification index), 70,76,77,79,103,104,106,107,109,110 and we calculated the sensitivity, specificity, and OR of recognition using data presented in 5 of them.…”

Section: Resultsmentioning

confidence: 99%

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Recognition of Depression by Non-psychiatric Physicians—A Systematic Literature Review and Meta-analysis

et al. 2007

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Recognition of Depression by Non-psychiatric Physicians—A Systematic Literature Review and Meta-analysis

et al. 2007

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“…This relies on general ward staff to detect psychiatric illness and refer appropriately, then act on the psychiatrist's recommendations. There are deficiencies at each of these stages (Popkin et al, 1984;Gustafson et al, 1991;Bowler et al, 1994;Gater et al, 1998;Balestrieri et al, 2002), some of which may be due to ageism (Hillerbrand, 1989), but these deficiencies can be overcome; for example, non-psychiatric staff can be trained to recognise cognitive impairment successfully (Berkowitz, 1981), and protocols to manage delirium have beneficial results (Inouye et al, 1999). The development of liaison psychiatry service models integrated into general hospital services, educating general hospital staff and proactively seeking referrals rather than simply waiting for consultation requests, may be an effective way of tackling these deficiencies.…”

Section: Discussionmentioning

confidence: 99%

A UK survey of psychiatric services for older people in general hospitals

Holmes

Bentley

Cameron

2003

Int J Geriat Psychiatry

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SUMMARYBackground Psychiatric illness is common in older people in general hospitals, but little is known of the service models operating in the UK, or of the views of old age psychiatrists regarding service provision in this area. We set out to determine the range of UK old age psychiatry service models for older people in general hospital wards, and the opinions of clinicians on future service priorities and development. Method A postal questionnaire survey of old age psychiatrists providing psychiatric services to older people in general hospital wards. Results 73% of services were provided through a generic, sector-based, consultation psychiatry model. The remaining 27% employed a range of general hospital-based liaison psychiatry services for older people, involved in proactively seeking referrals and educating general hospital staff. Those providing a generic sector-based model were significantly slower at responding to referrals. 89% of respondents were unhappy with their service to older people in general hospital wards, with only 11% preferring the generic sector-based model. Organisational barriers to change identified included the management of mental health care and physical care by different organisations. Training, both of psychiatric staff in this specialist area, and of general hospital staff in the detection and basic management of common psychiatric conditions in the general hospital setting, was felt to be necessary. Conclusions The management of co-morbid psychiatric and physical illness in older people is an important issue for health services. Old age psychiatrists are unhappy with the prevalent, reactive, consultation-based model, preferring a range of liaison psychiatry models based in the general hospital. The most important barriers to service development in this area were the separate managerial arrangements for psychiatric and physical care services, and a lack of evidence for effective old age psychiatry services in this setting.

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“…Despite its frequent occurrence and poor prognosis (Cole and Bellavance, 1997;McCusker et al, 2005), major depression in older medical inpatients is usually not detected or treated (Balestrieri et al, 2002;Koenig et al, 1992). Most prior research in this population has measured the clinical course of depression using categorical diagnostic groups (Cole and Bellavance, 1997).…”

Section: Introductionmentioning

confidence: 99%