Psychological Distress and Cognitive Impairment in Neurological In-Patients: Its Prevalence and its Recognition by Residents

Abstract

Objective:

This pilot study investigated the prevalence of psychological distress and cognitive impairment in neurological in-patients by means of three widely accepted questionnaires. We examined residents' recognition of corresponding disturbances.

Method:

We interviewed fifty-five consecutively admitted in-patients of a neurological unit with the MMSE, GHQ-28 and BDI. We asked the neurological residents whether they found cognitive impairment or psychological disturbances in their patients and to indicate the extent of those abnormalities.

Results:

Fifteen percent of patients showed cognitive impairment, but as many as one-third showed psychological problems warranting further work-up. Recognition of such by residents as well as specification of psychiatric diagnoses and important psychosocial factors in the final reports was poor.

Conclusion:

Psychological problems are common in neurologic in-patients. They are insufficiently recognized by residents and usually not taken into consideration in patient-care. We suggest the improvement of neurologic training to include appropriate interview techniques, providing the integration of biological, psychological and social factors in diagnosis and therapy.