Prevalence of unrecognized depression in patients admitted in medical and surgical departments of a tertiary care hospital: a comparative analysis, Karachi, Pakistan

Objective The aim of this study was to assess the frequency of depression in medical and surgical department using PHQ-9 questionnaire and to compare the incidence of depression in acute and chronic medical and surgical patients. Material and Methods This cross-sectional comparative analysis was conducted from April 2013 to March 2014. All patients admitted in the medicine and surgical departments were enrolled in the study. Patients with known history of depression or any other psychiatric history or on anti-depressants or on anti-psychotics were excluded from the study. Patients presenting with self-poisoning or any other suicidal attempt were also excluded from the study. Two residents from each department were trained to interview the patients according to the PHQ-9 questionnaire. The prevalence of depression was then seen in surgical and medical patients. Depression and its severity was seen and compared between the acute and chronic disorders of surgical and medical patients. Depression was also seen in between both genders in medical and surgical patients. Statistical analysis was performed using SPSS (IBM SPSS Statistics 20.0). Results A total of 748 patients were enrolled in which 399 patients and 349 patients were enrolled from the medicine and surgery department respectively. The mean age was 46.14 + 15 years of medical patients and 40.23 + 15 years of surgical patients. Among the 399 medical patients 233 (58.4%) were males, 349 surgical patients 178 (58%) were males. Gender was not found to be significantly associated with depression in medical (p= 0.367) and in surgical patients (p=0.606). Minimal depression was found in 48 (12%) medical patients and 131 (37.5%) surgical patients. Moderately severe and severe depression was found in 33 (8.3%) and 37 (9.3%) in medical patients respectively. While in surgical patients moderately severe depression was seen in 42 (12%) and severe depression was seen in 9 (2.6%) patients. Depression was significantly associated with acute and chronic medical disorders with a p<0.001.Depression was not significantly associated with acute and chronic surgical disorders with a p=0.059. Conclusion Unrecognized depression is a major health burden in Pakistan, and depression was significantly associated with acute and chronic medical disorders.sch_podpub3826pu