Recognition of psychiatric disorders in musculoskeletal and cardiovascular rehabilitation patients1☆,
Section snippets
Study design and sample
The study sample was taken from 10 rehabilitation hospitals in southwest Germany. Within a determined time period, all newly admitted patients were consecutively examined to minimize selection bias before screening.
The study protocol was designed to select 800 patients with the diagnosis of musculoskeletal disease and 800 patients with CVDs, for screening with the General Health Questionnaire (GHQ-12). Ten percent of low GHQ scorers, 30% of medium GHQ scorers, and 50% of high GHQ scorers were
Musculoskeletal diseases
A total of 672 patients with musculoskeletal diseases from 4 orthopedic rehabilitation hospitals filled in the set of questionnaires, and 205 were interviewed with the M-CIDI. One of the cooperating orthopedic rehabilitation hospitals also specializes in psychosomatic diseases. The interviewed patients had a mean age of 49 years (range, 22–75y). Seventy-four percent were still employed during the study period, and most (99%) were German citizens. The orthopedic diagnoses of the examined sample
Discussion
More than 31% of rehabilitation inpatients with musculoskeletal disorders and almost 20% of the patients with CVDs had current psychiatric symptoms.13 Considering the influences comorbid psychiatric disorders can have on QOL and rehabilitation outcome, it is important to learn to what extent psychologic problems are detected during rehabilitation. Furthermore, it is relevant to analyze the detection rate for assignment to psychosocial treatment.
Analysis of the discharge reports showed that only
Conclusions
Despite the limitations mentioned above, this study showed a need for improved diagnostics of mental disorders in medical rehabilitation. In particular, differential diagnostic skills need to be taught. The recognition of psychologic syndromes can be improved using the following course of action. First, all patients undergoing medical rehabilitation should be examined with brief screening scales during the first days of their inpatient treatment.46, 47 Second, it is important to choose adequate
Acknowledgements
We thank the following rehabilitation hospitals for their cooperation and their support in collecting the data: Theresienklinik, Bad Krozingen; Ziegelfeldklinik, St. Blasien; Schwarzwaldklinik, Bad Krozingen; Breisgauklinik, Bad Krozingen; Herz-Kreislauf-Klinik, Waldkirch; Klinik Baden, Bad Krozingen; Klinik Lazariterhof, Bad Krozingen; Rehabilitationsklinik Sinnighofen, Bad Krozingen; and Rheintal-Klinik, Bad Krozingen.
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Supported by the Freiburg/Bad Säckingen Rehabilitation Research Network (grant nos. 01 GD 9802/4, 01 GD 0101), the Federal Ministry of Education and Research, and the Federation of German Pension Insurance Institutes.
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