Psychosomatics
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The purpose of this study was to determine the threshold at which depression becomes important for the daily functioning of patients with heart disease. Data from a 1-year prospective cohort study of health maintenance organization patients undergoing coronary angiography for coronary heart disease were analyzed for differences in a standardized composite measure of functioning. ⋯ The major and minor depression groups did not differ significantly. The significance of the depression group differences was reduced, but not eliminated, when controlling for differences in reported heart symptoms.
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In addition to diagnostic criteria, delirium research requires standardized instruments to measure symptoms. This article reviews the literature about the Delirium Rating Scale (DRS), the most widely used scale to assess delirium that has been translated into at least seven other languages. The DRS has 10 items and is clinician-rated, but 7- or 8-item subscale adaptations have been used for repeated measurements. ⋯ Tables summarize details from various studies. The DRS is used clinically and in research. It is currently being revised to enhance its use in phenomenologic and treatment research.
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Comparative Study
Comparing emergency department and psychiatric setting patients with panic disorder.
In a recent study, the authors reported that 25% (108/441) of consecutive emergency department (ED) chest pain patients had panic disorder (PD). As part of this study, the authors sought to answer the question: How do ED patients with PD compare with patients with PD who seek treatment in a psychiatric setting? PD patients from an ED (n = 108) and psychiatric clinic (n = 137) were compared with respect to comorbid Axis I diagnoses, self-report scores, and recent suicidal ideation. The group of psychiatric patients was younger (36.5 vs. 52.3 years) (P < 0.0001) and consisted of proportionally more women (63% vs. 39%) (P = 0.0001) than the ED patients. ⋯ Both groups also did not differ on the Beck Depression Inventory and in their rate of report of recent suicidal ideation (32% vs. 25%) (P = 0.23). Both psychiatric and ED patients with PD appear to be highly distressed patients who require treatment. Early intervention for ED patients may prevent both chronic patient distress and development of the significant phobic avoidance observed in psychiatric patients.