Cedars-Sinai nurses screening hospitalized patients for signs of depression

In an effort to identify and treat patients with undiagnosed depression, Cedars-Sinai nurses are screening each hospitalized patient for signs of the illness and for risk factors that could make recoveries harder and longer.

The new initiative is believed to be one of the broadest depression screening of patients in a U.S. medical center.

Although many illnesses are associated with some feelings of anxiety, stress and fear, the new screening process is designed specifically to help detect symptoms of clinical depression characterized by a severely disheartened mood, lowered activity level and persistent negative thoughts lasting longer than two weeks. More than 18 million Americans about - 7 percent of the adult population - experience major depression each year.

"Society's stigma against those who have a mental illness often prevents people from seeking treatment when they start feeling depressed," said Itai Danovitch, MD, MBA, chair of the Cedars-Sinai Department of Psychiatry. "If they develop a physical condition that requires hospitalization, it can cause depression to worsen, affecting the patient's ability to bounce back from a physical illness. Instituting comprehensive screening will help us recognize underlying mental health issues and offer effective treatments more readily."

Depression affects a large number of patients who enter hospitals and is thought to be caused by a combination of genetic, biological, psychological and environmental factors.

"We know, based on multiple medical studies over several years, that addressing depression improves all aspects of patient health," said Linda Burnes Bolton, DrPH, RN, vice president for nursing, chief nursing officer and director of Nursing Research. "By routinely screening our patients for depression upon admission, we can ensure that they receive the appropriate treatment and protocol."

A registered nurse will interview each patient within 24 hours of admission, Danovitch said, and ask two questions about mood and energy level. If the patient's answers indicate a possible diagnosis of depression, the nurse will immediately use a standardized, detailed questionnaire to assess concentration, appetite, sleep patterns and the presence of any thoughts of suicide. Cedars-Sinai social workers, partnering with physicians, will help determine appropriate interventions.

If the questionnaire reveals that a patient is actively suicidal, the Nursing Department will notify the patient's physician and institute safeguards designed to protect a patient from self-harm.