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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Dr. Sebastian Schulz-Stübner
Rotackerstraße 25
79104 Freiburg im Breisgau
eMail: E-Mail: schust@t-online.de