Thesis
Psychiatric illnesses in general hospital inpatients
- Abstract:
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Background: Psychiatric illnesses are problematic in the medically ill, particularly amongst those admitted to general hospitals. An admission to a general hospital provides the opportunity to identify and, where appropriate, treat these conditions. To achieve this by better psychiatric service provision, we first need to know how common psychiatric illnesses are in general hospital inpatients.
Research aim: The overall aim of this thesis was therefore to determine the prevalence of psychiatric illnesses in general hospital inpatients.
Methods: I conducted: (1) a meta-review of the prevalence of psychiatric illnesses in general hospital inpatients; (2) a systematic review of the prevalence of anxiety disorders in general hospital inpatients; and (3) a cross-sectional study of the prevalence and associations of clinically significant anxiety, depression and cognitive impairment in older general hospital inpatients.
Results: The main findings of this thesis are as follows:
(1) Meta-review: The prevalence of diagnosed: depression ranged from 2% to 56% in general hospital inpatients (mean prevalence of 12%); delirium ranged from 10% to 31% in medical inpatients at admission to hospital; and dementia ranged from 2.8% to 63.0% in older general hospital inpatients. I did not find a systematic review of the prevalence of anxiety in the whole population of general hospital inpatients; therefore, I systematically reviewed this literature.
(2) Systematic review: The mean prevalence of panic disorder was 2% and generalised anxiety disorder was 7% in general medical and surgical inpatients.
(3) Cross-sectional study: The prevalence of clinically significant anxiety, depression and cognitive impairment was 41.8%, 43.6% and 64.1% respectively in older general hospital inpatients. I found evidence to suggest psychiatric illnesses were especially common in the “sickest” patients and those without a spouse or partner. Patients with clinically significant anxiety or depression also appeared to be more likely to experience symptoms of other psychiatric illnesses.
Conclusion: The finding that psychiatric illnesses are highly prevalent in general hospital inpatients has important implications for clinical care and healthcare policy. In particular, it suggests that general hospital services must address the needs of patients suffering from both medical and psychiatric illnesses. Better psychiatric care provision in general hospitals has the potential to improve outcomes for these patients.
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(Preview, Dissemination version, pdf, 2.5MB, Terms of use)
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Authors
Contributors
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Psychiatry
- Sub department:
- Psychiatry
- Research group:
- Psychological Medicine Research Group
- Role:
- Supervisor
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Psychiatry
- Sub department:
- Psychiatry
- Research group:
- Psychological Medicine Research Group
- Oxford college:
- St Cross College
- Role:
- Supervisor
- ORCID:
- 0000-0002-6474-9980
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Psychiatry
- Sub department:
- Psychiatry
- Research group:
- Neurobiology of Ageing Group
- Oxford college:
- Linacre College
- Role:
- Examiner
- ORCID:
- https://orcid.org/0000-0002-5190-7038
- Institution:
- University of Edinburgh
- Research group:
- Centre for Clinical Brain Sciences
- Role:
- Examiner
- Funding agency for:
- Walker, J
- Sharpe, M
- Programme:
- In this thesis, I used data collected from patients who had agreed to participate in The HOME Study, which was funded by the National Institute for Health Research Health Services and Delivery Research Programme.
- DOI:
- Type of award:
- DPhil
- Level of award:
- Doctoral
- Awarding institution:
- University of Oxford
- Language:
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English
- Keywords:
- Subjects:
- Deposit date:
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2021-04-12
Terms of use
- Copyright holder:
- van Niekerk, M
- Copyright date:
- 2020
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