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What is the “mask” of depressed inpatients from the viewpoint of surgeons and internal medicine physicians?

Objective. Depressed inpatients are easily misrecognized by general hospital physicians. Therefore, our study aimed to examine the following issues: (1) how primary care doctors recognize depressed inpatients; (2) if there are any differences between internal medicine physicians and surgeons with regard to this recognition; (3) the factors associated with the accurate recognition of depression. Methods. Four hundred and twenty-five consecutive patients from internal medical or surgical wards who had been diagnosed with depression were enrolled in this study. The reasons for referral were recorded from the referral sheet. Accurate recognition of depression was defined as depressive disorder or depressed core symptoms, which were the reasons for referral. Results. The rate of correct recognition of depression was the same for both physicians and surgeons. Depressed inpatients from the internal medicine wards were referred more commonly for suicide problems and unexplained physical symptoms, while a greater number of depressed patients from the surgical wards were referred for insomnia, agitation/irritability, cognitive impairment, and past psychiatric history. Multiple physical comorbidities, depression treatment history, and depression of a higher severity were independent factors associated with accurate recognition. Conclusions. Postgraduate education is still needed with regarded to understanding depression. The educational content should be specific to the different specialties and the patient characteristics in different wards