Why Aren’t All Hospital Patients Screened for Depression?


Let’s face it: being in the hospital can be depressing.

While medical research on this topic does come with a certain “duh” factor, the study published in Journal of Hospital Medicine raises some important points.

Namely, why aren’t we screening hospitalized patients for depression, just as we do for high blood pressure or diabetes?

Credit: pongmoji/123RF Stock Photo

“Upon admission to the hospital, patients are screened for all kinds of medical issues such as abnormalities in blood pressure, cholesterol and blood sugar,” said Dr. Waguih William IsHak, lead author of the study, in a Cedars-Sinai Medical Center news release.

“Adding a screening for depression seizes a golden opportunity to initiate and maintain treatment,” he stressed.

The authors arrived at the conclusion that about one in three hospital patients is depressed. They did so after reviewing other peer-reviewed articles on the topic.

“The prevalence of depression ranged from 5 percent to 60 percent, with a median of 33 percent, among hospitalized patients,” the authors state in their abstract.

“With regard to outcomes, studies from several individual hospitals found depression to be associated with poorer functional outcomes, worse physical health, and returns to the hospital after discharge,” the abstract continues.

Depression Is Expensive

Depression costs our nation’s economy $210 billion per year, according to Scientific American. But only $40 billion of that is related to the depression itself, according to the blog.

Most of the costs of depression are for related mental illnesses, such as anxiety and post-traumatic stress disorder, as well as for physical illnesses, such as back disorders, sleep disorders and migraines,” writes Paul E. Greenberg, Director of the Health Care Practice at Analysis Group, an economics consulting firm that provides health outcomes research in medical and complex legal matters.

Related: Teen Depression May Be Linked to Hippocampus Size

“In fact, for every dollar spent treating depression, an additional $4.70 is spent on direct and indirect costs of related illnesses, and another $1.90 is spent on a combination of reduced workplace productivity and the economic costs associated with suicide directly linked to depression,” according to Greenberg.

When patients are depressed upon release from the hospital, they may not take their medications properly or eat well when they get home. People who live alone, including the elderly and some people with disabilities, can be particularly vulnerable.

And when a patient ends up in the hospital again, their primary ailment probably still will not be resolved due to poor after care upon discharge. The depression possibly could be aggravated by the first hospital stay as well as an inability to recover.

Related: Video Games May Help People Deal With Depression

“We know that depression is a serious factor in any patient’s recovery,” IsHak said. “These findings show that hospitals might experience improved outcomes by initiating a depression screening program.”

Cedars-Sinai Hospital in Los Angeles routinely screens for depression.

“Patients who screen positive for depressive symptoms receive interventions from their Cedars-Sinai admitting physicians, social workers and the psychiatry team, which includes psychiatrists, psychologists, psychiatric social workers and a psychiatric nurse,” according to the news release.