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Association Between Depressive Symptoms and Mortality in Medical Inpatients

Received October 13, 1999; revised February 4, 2000; accepted April 27, 2000. From the Department of Internal Medicine, Federal University of Santa Catarina, Brazil; the Departments of Psychiatry and Preventive Medicine, Rush Medical College, Rush-Presbyterian St. Luke's Medical Center, Chicago, Illinois; and the Department of Psychiatry, Federal University of Rio de Janeiro, Brazil. Address reprint requests to Dr. Furlanetto, Departamento de clinica medica, Hospital Universitario, Universidade Federal de Santa Catarina, P.O. Box: 5199, Florianópolis, SC, Brazil; e-mail leticia{at}hu.usfc.br

The authors interviewed a consecutive series of medical inpatients (N=241) using the Schedule for Affective Disorders and Schizophrenia to determine which depressive symptoms are associated with in-hospital mortality. Fifteen depressive symptoms, pain, and physical discomfort were assessed along with medical comorbidity. Twenty patients died in-hospital (8.3%). Logistic regression showed that anhedonia, hopelessness, worthlessness, indecisiveness, and insomnia predicted in-hospital death after adjusting for physical comorbidity and age. Clinicians should be aware that these depressive symptoms may predict mortality in medical inpatients. Future studies should address which treatment modalities lead to better outcomes.

Key Words: Depression • Prognosis • Mortality

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