Diagnosing Depression in Medical Inpatients
Authors: JOHN J. SCHWAB
Journal: Annals of Internal Medicine (1967)

Article1 October 1967Diagnosing Depression in Medical InpatientsJOHN J. SCHWAB, M.D., MARTIN BIALOW, M.D., JUDITH M. BROWN, M.A., CHARLES E. HOLZER, B.A.JOHN J. SCHWAB, M.D., MARTIN BIALOW, M.D., JUDITH M. BROWN, M.A., CHARLES E. HOLZER, B.A.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-4-695 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSince the days of hippocrates, depression has been recognized as a distinctive psychobiologic mode. Engel (1) said that depression, developmentally, is the latter of two basic biologic reactions, anxiety being the first. Historically, depression has been known as melancholia, and descriptions are colorful and insightful. Hippocrates spoke of melancholic individuals as "lean, withered, hollow-eyed, with flaggy beards and . . . fearful dreams." Galen observed that "many fear death and yet, in a contrary humor, make away with themselves." The great physicians were impressed with the manifold symptomatology. InThe Anatomy of MelancholyBurton (2), reviewing the writings up to...References1. ENGEL G: Psychological Development in Health and Disease. W. B. Saunders Co., Philadelphia, 1962. Google Scholar2. BURTON R: The Anatomy of Melancholy. Tudor Publishing Co., New York, 1927. Google Scholar3. FREUD S: Collected Papers. Hogarth Press, London, 5 volumes, various dates. Google Scholar4. ABRAHAM K: Selected Papers on Psychoanalysis. Hogarth Press, London, 1927, chaps. 24 and 26. Google Scholar5. KLEIN M: The Psychoanalysis of Children. Hogarth Press, London, 1932. Google Scholar6. FENICHEL O: The Psychoanalytic Theory of Neurosis. W. W. Norton & Co., New York, 1945. Google Scholar7. JACOBSON E: Contribution to the metapsychology of cyclothymic depression, in Affective Disorders, edited by GREENACRE, P. International Universities Press, New York, 1953, pp. 49-83. Google Scholar8. GRINKERMILLERSABSHINNUNNNUNNALLY RRJMRJC: The Phenomena of Depressions. Hoeber Medical Division, Harper & Row, Inc., New York, 1961. Google Scholar9. RIPLEY H: Depressive reactions in a general hospital. J. Nerv. Ment. Dis. 105: 607, 1947. CrossrefMedlineGoogle Scholar10. SCHWABCLEMMONSFREEMONSCOTT JJRSFRML: Differential characteristics of medical in-patients referred for psychiatric consultation: a controlled study. Psychosom. Med. 27: 112, 1965. CrossrefMedlineGoogle Scholar11. BECKWARDMENDELSONMOCKERBAUGH ATCHMJJ: An inventory for measuring depression. Arch. Gen. Psychiat. (Chicago) 4: 561, 1961. CrossrefMedlineGoogle Scholar12. SCHWABBIALOWCLEMMONSMARTINHOLZER JJMRRSPCE: The Beck Depression Inventory with medical inpatients. Acta Psychiat. Scand. In press. Google Scholar13. HAMILTON M: A rating scale for depression. J. Neurol. Neurosurg. Psychiat. 23: 56, 1960. CrossrefMedlineGoogle Scholar14. SCHWABBIALOWCLEMMONSHOLZER JJMRRSCE: The Hamilton Rating Scale for Depression with medical inpatients. Brit. J. Psychiat. 113: 83, 1967. CrossrefMedlineGoogle Scholar15. SCHWABBIALOWHOLZERBROWNSTEVENSON JJMRCEJMBE: Sociocultural aspects of depression in medical inpatients. I. Frequency and social variables. Arch. Gen. Psychiat. (Chicago). In press. Google Scholar16. SCHWABBROWNHOLZER JJJMCE: Relationships between depression and gastrointestinal illness. Gastroenterology. In press. Google Scholar17. SROLELANGNERMICHAELOPLERRENNIE LTSSTMKTA: Mental Health in the Metropolis: The Midtown Manhattan Study, vol. I. McGraw-Hill Book Co., Inc., New York, 1962, p. 201. CrossrefGoogle Scholar18. SCOTT WA: Social psychological correlates of mental illness and mental health. Psychol. Bull. 55: 65, 1958. CrossrefMedlineGoogle Scholar19. SCHWABBIALOWHOLZER JJMRCE: A comparison of two rating scales for depression. J. Clin. Psychol. 23: 94, 1967. CrossrefMedlineGoogle Scholar20. SCHWABBROWNHOLZER JJJMCE: Depression in medical inpatients: age and sex differences. Ment. Hyg. In press. Google Scholar21. DEWAN JG: Mild depression. Med. Clin. N. Amer. p. 527, March 1952. CrossrefMedlineGoogle Scholar22. CHALGREN W: Physical symptoms of depression. Minnesota Med. 36: 148, 1953. MedlineGoogle Scholar23. CLEGHORNCURTIS RAGC: Depression: mood, symptom, syndrome, in Acta Psychosomatica Documenta Geigy, no. 2, North American Series. J. R. Geigy S.A., Basel, 1959. Google Scholar24. KIELHOLZ P: Diagnosis and therapy of the depressive state. Ibid. Google Scholar25. EWALT JR: Somatic equivalents of depressions. J. Mich. Med. Soc. 59: 1361, 1960. MedlineGoogle Scholar26. SCHOTTSTAEDT WS: Psychophysiologic Approach to Medical Practice. Year Book Medical Publishers, Inc., Chicago, 1960. Google Scholar27. HENDERSONGILLESPIEBATCHELER DRI: A Textbook of Psychiatry. Oxford University Press, Inc., London, 1956. Google Scholar28. EBAUGH F: The depressed patient, in Management of Emotional Problems in Medical Practice, edited by LIEBMAN, S. J. B. Lippincott Co., Philadelphia, 1956. Google Scholar29. KRAINES SH: Mental Depressions and Their Treatment. The Macmillan Co., New York, 1957. Google Scholar30. NOYESKOLB AL: Modern Clinical Psychiatry, 5th ed. W. B. Saunders Co., Philadelphia, 1958. Google Scholar31. STOECKLEDAVIDSON JDGE: Bodily complaints and other symptoms of depressive reaction. Diagnosis and significance in a medical clinic. JAMA 180: 134, 1962. CrossrefMedlineGoogle Scholar32. SCHWABBIALOWBROWNHOLZERSTEVENSON JJMRJMCEBE: Sociocultural aspects of depression in medical inpatients. II. Symptomatology and class. Arch. Gen. Psychiat. (Chicago). In press. Google Scholar33. DEWHURST WG: On the chemical basis of mood. J. Psychosom. Res. 9: 115, 1965. CrossrefMedlineGoogle Scholar34. GRESHAMAGNEWWILLIAMS SCHWRL: The sleep of depressed patients. An EEG and eye movement study. Arch. Gen. Psychiat. (Chicago) 13: 503, 1965. CrossrefMedlineGoogle Scholar35. SCHWABBIALOWCLEMMONSHOLZER JJMRRSCE: The affective symptomatology of depression in medical inpatients. Psychosomatics 7: 214, 1966. CrossrefMedlineGoogle Scholar36. SCHWABCLEMMONSBIALOWDUGGANDAVIS JJRSMVBF: A study of the somatic symptomatology of depression in medical inpatients. Psychosomatics 6: 273, 1965. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Gainesville, FloridaFrom the Department of Psychiatry, University of Florida College of Medicine, Gainesville, Fla.This study was supported in part by grant MH 2152-02, National Institute of Mental Health, National Institutes of Health, Bethesda, Md.This work was presented at the 48th Annual Session of the American College of Physicians, San Francisco, Calif., April 12, 1967.Requests for reprints should be addressed to John J. Schwab, M.D., Department of Psychiatry, J. Hillis Miller Health Center, University of Florida, Gainesville, Fla. 32601. Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPsychometric Properties of the Five Facets Mindfulness Questionnaire in Moderate-to-Severe, Persistent DepressionPsychiatric Issues in Cancer PatientsPsychiatric considerations in the oncology settingOmega-3 fatty acids: physiology, biological sources and potential applications in supportive cancer careThe course of anxiety and depression in surgical and non-surgical patientsTreatment of psychological co-morbidities in common gastrointestinal and hepatologic disordersScreening new cancer patients for psychological distress using the hospital anxiety and depression scalePersistent posttreatment depressive symptoms in patients with head and neck cancerA Qualitative Examination of the Experience of 'Depression' in Hospitalized Medically Ill PatientsThe Utility of Somatic Items in the Assessment of Depression in Patients With Chronic PainPsychiatric issues in older cancer patientsPrevalence of depression in different groups of inpatients at the University Hospital of Bahia, BrazilA confirmatory factor analysis of the Beck Depression Inventory in chronic painDepression among hospitalised medically ill patients: a two-stage screening studyPsychiatric Manifestations of Cushing's SyndromeInpatient Depression in Persons with BurnsHigh Rates of Depressive Symptoms in STD Clinic PatientsMental Disorders in Medical Inpatients and the Association to Severity of Illness, Self-Rated Physical Disability, and Health PerceptionAccuracy of recognition and diagnosis of comorbid depression in the nursing homeDepression in breast cancer patients: The need for treatmentThe Evaluation of Depression in Inpatients with HIV DiseaseThe Role of Medical Conditions and Depression in the Functional Outcome of Stroke Survivors: A Review and Pilot StudyLiteraturverzeichnisSelf-rated depression in 12,063 middle-aged adultsDepression in patients with pancreatic carcinoma: Diagnostic and treatment issuesDepression in patients with pancreatic carcinoma: Diagnostic and treatment issuesThe Effects of Depression and Chronic Pain on Psychosocial and Physical FunctioningA Model for Evaluating the Impact of Consultation-Liaison Psychiatry Activities on Referral PatternsThe Prevalence of Major Depressive Disorder and Low Self-Esteem in Medical InpatientsDepression in the Medically Ill Elderly: A Focus on MethylphenidatePrevalence of Psychiatric Disorders in Medical InpatientsDelirium Presenting With Symptoms of DepressionReligious Coping and Cognitive Symptoms of Depression in Elderly Medical PatientsReview of depression in cancer: Gender differencesDepression in the Medically IllPain and depression in patients with cancerDepression and suicide in patients with cancerRelationship of Gender, Self-Esteem, Social Class, and Racial Identity to Depression in BlacksDepression in hospitalized medically ill elders: Evolution of the conceptDepression in Disabling Illness: Severity and Patterns of Self-Reported Symptoms in Three GroupsDetecting depression in chronic pain patients: Adequacy of self-reportsWhat does the BDI measure in chronic pain?Profile of Depressive Symptoms in Younger and Older Medical Inpatients with Major DepressionProblems of Drop-out in the Self-help Treatment of Chronic, Occupational Pain of the Upper LimbsEvaluation of the hospital anxiety and depression scale as a screening instrument in geriatric medical inpatientsMajor depression and adjustment disorder with depressed mood or depressive disordersThe functional and psychological status of patients with amyotrophic lateral sclerosis: Some implications for rehabilitationDepression and self-esteem: Rapid screening for depression in black, low literacy, hospitalized tuberculosis patientsPhysical Symptoms and Depressive Symptoms Among Individuals With HIV InfectionResolution of Depressive Symptoms in Medical Inpatients after DischargeDetection of Depression in the Stroke PatientStructured ambiguity and the definition of psychiatric illness: Adjustment disorder among medical inpatientsSelf-Rated Depressive Symptoms in Medical Inpatients: Age and Racial DifferencesThe cancer patient with pain: Psychiatric complications and their managementGeriatric Preventive Care: Counseling Techniques in Practice SettingsPhysical consequences of depression in the stroke patientMood Disorders and SuicideMeasurement of depression: Comparison between self-reports and clinical assessments of depressed outpatientsPsychiatric Aspects of Chest Pain in the Emergency DepartmentMajor Depressive Disorder in Hospitalized Medically Ill Patients: An Examination of Young and Elderly Male VeteransDeterminants of somatization in primary careDepression, disease and disability: application to patients with traumatic spinal cord injuryCognitive-behaviour therapy in the treatment of chronic, occupational pain of the upper limbs: a 2 yr follow-upConsultation/liaison psychiatry: the state of the art and future developmentsDiagnosing Depression in Patients With Medical IllnessSelf-Report Symptoms That Predict Major Depression in Patients with Prominent Physical SymptomsScreening for Depression in Primary Care Clinics: The CES-D and the BDIUse of Antidepressants in Medically Ill Older PatientsInventaires d'auto-évaluation de la psychopathologie chez l'adulte. 2 e partie: inventaires de dépressionThe Beck Depression Inventory as a Screening Device for Major Depression in Renal Dialysis PatientsDiagnostic characteristics and dispositions in suicidal hospitalized medical and surgical patientsDepression and abnormal illness behavior in cancer patientsDepression Following Spinal Cord InjuryDepression among general hospital patients in GreecePsychological Aspects of Pain Due to CancerEmotional and cognitive dysfunction associated with medical disordersIdentifying Depression in Medical PatientsPrevalence and Recognition of Depressive Disorders in General Medical InpatientsDepression in torticollis: a controlled studyPost-Stroke Depression: A Critical Review of the Literature*Severe Illness in Older Patients: The Association Between Depressive Disorders and Functional Dependency During the Recovery PhaseSelf-Rated Depression Scales and Screening for Major Depression in the Older Hospitalized Patient with Medical IllnessDepression and disability in the elderly: Reciprocal relations and changes with ageDepression and the Physical EnvironmentPsychological distress in geriatric and adult medical in-patientsPsychiatric Consultations in Rheumatology: A Review of 100 CasesPsychometric properties of the Beck Depression Inventory: Twenty-five years of evaluationLa dépression dans les populations médicalesDepression in patients referred for psychiatric consultationA comparison of the symptoms of medical and psychiatric patients matched on the Beck Depression InventoryAssessment of Depression in Geriatric Medical Outpatients: The Validity of Two Screening MeasuresDepressive Symptoms in Children and Adolescents With Cancer: A Longitudinal StudyPsychopathology in Medical Inpatients and its Relationship to Length of Hospital Stay: A Pilot StudyWhy do some psychiatric patients somatize?Anxiety and depression among medical and surgical patients nearing hospital dischargeThe Cancer Patient with Pain: Psychiatric Complications and Their ManagementRelation of Depression to Specific Medical Complaints in Psychiatric InpatientsOld People in Hospital: A Study of a Psychiatric High-Risk GroupCoping behaviors among depressed and nondepressed medical inpatientsA framework for the study of medical depressionAssessment of depression in an elderly medical populationAssessment of Depression and Cognitive Impairment After Hip FractureFactors Affecting Anxiety and Depression in Psychiatric Consultation PatientsDepression and physical illness among elderly general medical clinic patientsDepression in geriatric and adult medical inpatientsThe Hannover consultation liaison model: Some empirical findingsPrevalence of Depression and Anxiety in Patients with COPDLiaison psychiatry in an Indian general hospitalAnxiety and Depression in Geriatric and Adult Medical Inpatients: A ComparisonPsychiatric illness in inpatients with neurological disorders: patients' views on discussion of emotional problems with neurologists.Depression in Canadian General Practice AttendersLaboratory Evaluation of Newly Admitted Psychiatric PatientsRisk factors and the prevalence of depression in Mormon womenEvaluation of Treatment ResultsThe Quinolizinium Ion and Aza AnalogsVolume 2 ReferencesAnticonformity aspects of depression in mild depressive statesDiagnosing depression in the hospitalized medically illThe depressed mother as a source of stimulation for her infantPsychiatric consultation: A survey and review of utilizationThe prevalence of emotional and cognitive dysfunction in a general medical population: Using the MMSE, GHQ, and BDIFamily characteristics in high and low health care utilizationReactive Depression and Chronic Illness: Counseling Patients and Their FamiliesDepressive symptoms and abnormal illness behavior in general hospital patientsThe effect of pilgrimage on anxiety, depression and religious attitudePsychiatric illness in medical patients: Why it goes undiagnosedScreening for Depression in Hospitalized Geriatric Medical PatientsCollaborative Efforts in Liaison PsychiatryDiagnostic Considerations in the Medical SettingRelationship of depression to medical illnessUse of a psychodynamic life narrative in the treatment of depression in the physically illConsultation psychiatry in an Italian general hospitalCushing's Syndrome: A Psychiatric Study of 29 PatientsPsychiatric liaison: Benefits of an 'active' approachPsychiatric Illness among Medical PatientsA General Hospital Patient is Not a NUTMental disorders in cancer patients.A study of 100 psychiatric referralsPsychological Disturbances in Adults with Chronic Physical IllnessThe psychologist's role in psychosomaticsPain: The Most Common Psychosomatic ProblemDepression in Medical In-PatientsPsychiatry of somatic diseases: Epidemiology, pathogenesis, classificationPsychotropic Drugs in Somatic DisordersValidation of anxiety depression and denial scales in a coronary care unitScreening Depressed Patients in Family PracticeKlinik der NeurosenPsychiatric Consultation in a Coronary Care UnitN. H. CASSEM, M.D., THOMAS P. HACKETT, M.D.Conceptual Developments in Psychosomatic Medicine: 1939-1969CHASE PATTERSON KIMBALL, M.D.Toward a Concept of Comprehensive MedicineTreating Anxiety and DepressionCurrent Concepts of Depression: the Sociocultural 1 October 1967Volume 67, Issue 4Page: 695-707KeywordsAnxietyBiologicsFearInpatientsPsychiatry and mental health Issue Published: 1 October 1967 Copyright & PermissionsCopyright ©, 1967, by The American College of PhysiciansPDF downloadLoading ...