Comparison of components of the depression of hospitalized patients admitted through the emergency department or consultations.

Background: In a previous study, we investigated the risk of admission to emergency (ER) of depressed patients prior to their hospitalization in psychiatry in comparison with hospitalized patients transferred from the consultations department (Cdpt). In the present study, we compare among the same patients variables affecting the intensity of depression in each group.

Method: All patients with Major depressive disorder admitted in our department through emergencies (N=146) or consultations (N=2172) between January 1, 2010 and December 31, 2012 were included in an open study. They completed the Beck Depression Inventory (BDI), analogical visual scales about stress levels (in professional, social, family, married life, over the past year and the past month), the Multidimensional Health Locus of Control and the Olson Family Adaptation and Cohesion Scale and the Ways of coping.

Results: The depression (t=1.438; p=0.90) is similar in both samples. Although some variables such as gender, internality, coping mechanisms and stress factors influence the intensity of depression in both groups of patients (linear regression p<0.000, r=0.593), other factors play a role only in either one or the other group. The factors of patients' age, number of children, elements of family dynamics, couple life, and the belief in luck do influence the intensity of depression only in patients hospitalized through Cdpt (linear regression p<0.000, r=0.366). The intensity of depression of patients admitted through ER, is specifically dependent on the number of collateral factors (p=0.045, r=0.304), the number of living relatives (p=0.036, r=0.276) and the belief in the power of others (p=0.022, r=-0.16).

Conclusions: Although Both samples are comparable in terms of intensity of depression, patients admitted through the Cdpt are more dependent on the quality of family relationships whereas those coming from emergencies are most influenced by their concrete social and family situation. Alongside these specific variables it remains that stress and coping mechanisms account for the largest percentage of variance of the intensity of depression.