[Large differences in treatment of depression between departments of psychiatry]

A large proportion of patients admitted to psychological departments and wards suffer from depression. Knowledge is limited about the clinical aspects and treatment of depression at admission and discharge, as well as about the differences between psychiatric hospitals. The purpose of this study was to develop a database for patients admitted to a psychiatric department comprising registration of central clinical parameters.

A group of senior psychiatrists with research experience selected 12 central clinical and treatment parameters. All five hospitals in the Copenhagen area participated. Centralised training in the use of Hamilton Depression Rating Scale (HDRS) was performed. At discharge the scores on the various parameters were reported to a central database.

The educational HDRS ratings for the departments were rather uniform. The HDRS ratings and Beck Depression Inventory (BDI) ratings at admission and discharge were rather uniform between the participating departments. A large proportion of patients had depressive symptoms at discharge. The most prevalent antidepressants were newer selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors. Much variability was found in the use of medical augmentation strategies and in electroconvulsive therapy (ECT).

The severity of depression at admission and discharge were uniform across the participating departments. Many patients suffered from depressive symptoms at discharge. Much variability was found in the use of medical augmentation strategies and ECT.