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DOI: 10.1055/s-2001-14810
Georg Thieme Verlag Stuttgart - New York
Vergleich der Einschätzung von
Depressivität und Ängstlichkeit durch einen standardisierten
Fragebogen
oder Fremdbeobachtung in einer universitären
Prämedikationsambulanz
Validation of a an Observer-Based
Rating Set Compared to a Standardized Written Psychological Test (HADS-D) for
Diagnosis of Depression and Anxiety in an University Preadmission Test
Center
Publication History
Publication Date:
31 December 2001 (online)
Zusammenfassung.
Diese Pilotstudie zum Vergleich eines standardisierten psychologischen Testverfahrens (HADS-D) mit einem Fremdbeobachtungsset ergab in einer Stichprobe von 70 Patienten einer universitären Prämedikationsambulanz eine Prävalenz der Diagnose Depressivität von 7,14 % und Ängstlichkeit von 11,11 %. Die Fremdbeobachtung stimmte dabei in hohem Maße mit dem testpsychologischen Ergebnis überein und erscheint daher geeignet, um Patienten zu erkennen, die aufgrund ihrer ängstlichen oder depressiven Persönlichkeitsstruktur einer besonderen perioperativen Betreuung bedürfen und geeignete Maßnahmen zur Angstreduktion durch medikamentöse Therapie oder organisatorische Maßnahmen einzuleiten.
Validation of a an Observer-Based Rating Set Compared to a Standardized Written Psychological Test (HADS-D) for Diagnosis of Depression and Anxiety in an University Preadmission Test Center.
Introduction: Depression and anxiety can be a major factor of perioperative stress and might contribute to patients dissatisfaction with medical care if they remain unrecognized. There are several methods to diagnose depression and anxiety like standardized written psychological tests or self report scales. Because these tests are not always suitable for routine use in a busy preadmission test center we evaluated an observer-based rating set for the diagnosis of depression and anxiety. Material and Methods: 70 patients of a university hospital preadmission test center were tested with the HADS-D-Test and the observer-based rating set after approval of the institutional review board and written informed consent. Test-data were compared using a logistic regression model and demographic variables were analyzed using t-Test, ANOVA and Pearson correlation. Results: The prevalence of depression in our study population was 11,11 % (14,75 % in male, 9,76 % in female) and the prevalence of anxiety was 7,14 % (6,9 % in male and 7,32 % in female). The correlation between the observer-based rating items and the HADS-D-diagnosis was statistically highly significant. The observer based items “unsteady eye movements” and “general worrisome mood” proved to be especially sensitive for anxiety and the items “sorrowful mood” and “impression of resignation” were sensitive for depression without any influence of the experience of the anesthesiologist. A higher prevalence of depression and anxiety was found in patients with ASA-class III compared to those with ASA-classes I and II while age and type of surgery had no significant influence. Conclusions: Based on our observations depression and anxiety are a relevant factor of preoperative morbidity assessment. Observer-based items are a reliable tool to detect those patients which might need special assistance and therapy in the perioperative period to reduce stress associated with high preexisting levels of depression and anxiety.
Schlüsselwörter:
Depressivität - Ängstlichkeit - Prämedikation - perioperative Risikofaktoren
Key words:
- Depression - Anxiety - Premedication - Perioperative risk factors
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