The underdiagnosis of depression and anxiety in the medical complications, improve compliance to treatment, and facilitate the "appropriate" use of health care resources.

OBJECTIVES: To determine the prevalence of depression and/or anxiety in the in-patient medically ill and to validate the Hospital Anxiety and Depression Scale (HADS) for Filipinos.

METHODS: To aid clinicians, the Hospital Anxiety and Depression Scale (HADS), a 14-item self-report questionnaire was validated in this cross-sectional study of 710 medically ill in-patients, to be able to determine how well it identified depression and anxiety against the criterion of a diagnostic psychiatric interview and to determine the optimal cut-off score of the HADS for Filipinos with the use of the Receiver Operating Characteristics (ROC).

RESULTS: The prevalence of depression was 26.9% anxiety was 14.3%, and the 'mixed diagnosis' of both was 13.7% among the medically-ill. The overall prevalence was 54.9%. The results showed that the optimal cut-off score for the HADS/ HADS-P is a score of 11, with a sensitivity of 75%, specificity of 70% and PPV of 75%.

CONCLUSION: The HADS/ HADS-P will provide clinicians with a reliable, valid and practical screening tool for identifying the two most common clinical problems in the medically ill, depression and anxiety. The HADS/ HADS-P can serve as a guide for clinicians towards the diagnosis of depression and anxiety, but it cannot be the sole basis for diagnosis.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Depression ; Self Report ; 4-amino-4'-hydroxylaminodiphenylsulfone ; Anxiety ; Anxiety Disorders ; Depressive Disorder ; Sensitivity And Specificity

BACKGROUND: A reliable and socially validated definition of recovery in schizophrenia is essential to decrease stigma associated with the illness. This study aimed to define recovery in schizophrenia in the Philippine context, determine its specific elements, and describe methods of assessment in clinical practice. METHODS: We invited a group of purposively selected Filipino psychiatrists to participate in six simultaneous roundtable discussions to gather their opinions and perspectives on recovery in schizophrenia. Transcripts of the discussions were then subjected to framework analysis. RESULTS AND CONCLUSION Most Filipino psychiatrists were of the considered opinion that recovery in schizophrenia is possible, and their vision of a recovered patient resembles a combination of psychological and medical models. The mini-FROGS tool was deemed generally applicable in the Philippine setting except for self-esteem and sense of independence primarily because it is difficult to evaluate. The SWN was received with mixed reactions among the psychiatrists. Spirituality as an element of recovery and the family-oriented culture of the Filipinos were emphasized as important considerations in assessing patients. Other suggestions were given to tailor-fit these tools to the Philippine context.
Schizophrenia ; Philippines