General hospital psychiatry
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Gen Hosp Psychiatry · Sep 2007
Validity of the Hospital Anxiety and Depression Scale and Patient Health Questionnaire-9 to screen for depression in patients with coronary artery disease.
Depression is common but frequently undetected in patients with coronary artery disease (CAD). Self-report screening instruments for assessing depression such as the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire-9 (PHQ-9) are available but their validity is typically determined in depressed patients without comorbid somatic illness. We investigated the validity of these instruments relative to a referent diagnostic standard in recently hospitalized patients with CAD. ⋯ Both instruments have acceptable properties for detecting depression in recently hospitalized cardiac patients, and neither scale is statistically superior when summed scores are used. The categorical algorithm of the PHQ-9 for diagnosing major depression has a superior LR+ compared to the summed PHQ-9 and HADS scores. Use of the generally recommended cut-off scores should be cautious. In light of the aversive outcomes associated with depression in CAD, screening for depression is a clinical priority.
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Gen Hosp Psychiatry · May 2007
Comparative StudyImpact of war stress on posttraumatic stress symptoms in hospital personnel.
This study examines the relationship between exposure to war stress and posttraumatic symptoms among nurses and physicians in a general hospital targeted by missiles. ⋯ These findings show that nurses suffered from more severe posttraumatic symptoms compared to physicians after exposure to prolonged war stress. The gap between physicians and nurses warrants further study.
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We sought to assess the epidemiology of medication errors (MEs) and adverse drug events (ADEs) in a psychiatric hospital. ⋯ ADEs and serious MEs were common among psychiatric inpatients and similar to rates in studies of general hospital inpatients. Medication safety interventions targeting psychiatric care need further study.
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Gen Hosp Psychiatry · Jan 2007
Do psychiatric patients improve their competency to consent to hospitalization after admission? A prospective study in an acute inpatient ward.
Competency to consent to hospitalization has important clinical and ethical implications. However, there are no follow-up studies that evaluate improvement in competency during psychiatric hospitalization. The authors sought to determine whether patients admitted to a psychiatric ward as incompetent to consent to hospitalization improve their competency during hospitalization. ⋯ Nearly half of the patients who upon admission were incompetent remained incompetent at discharge.