Psychological Distress and Cognitive Impairment in Neurological In-Patients: Its Prevalence and its Recognition by Residents

Abstract

Objective:

This pilot study investigated the prevalence of psychological distress and cognitive impairment in neurological in-patients by means of three widely accepted questionnaires. We examined residents' recognition of corresponding disturbances.

Method:

We interviewed fifty-five consecutively admitted in-patients of a neurological unit with the MMSE, GHQ-28 and BDI. We asked the neurological residents whether they found cognitive impairment or psychological disturbances in their patients and to indicate the extent of those abnormalities.

Results:

Fifteen percent of patients showed cognitive impairment, but as many as one-third showed psychological problems warranting further work-up. Recognition of such by residents as well as specification of psychiatric diagnoses and important psychosocial factors in the final reports was poor.

Conclusion:

Psychological problems are common in neurologic in-patients. They are insufficiently recognized by residents and usually not taken into consideration in patient-care. We suggest the improvement of neurologic training to include appropriate interview techniques, providing the integration of biological, psychological and social factors in diagnosis and therapy.

Keywords

questionnaires MMSE GHQ BDI general hospital psychiatry epidemiology consultation and liaison psychiatry interview technique

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