Neurological comorbidity and psychological distress among depressed inpatients (Comorbilità per disturbi neurologici e distress psicologico in pazienti ricoverati per depressione)

Introduction. Comorbid neurological and psychiatric disorders are cause of concerns because they negatively affect outcomes and quality of life. Aims. To explore the association between higher levels of psychological distress and comorbid neurological disorders among depressed inpatients. Methods. A 10-month observational study on subjects consecutively admitted to a statutory in-patient service for non-acute psychiatric disorders. Psychiatric diagnosis was assessed using the Structured Clinical Interview for DSM-IV-TR (SCID I), Psychological Distress by the Kessler 10- Psychological Distress Scale (K10), potential neurological comorbidity by senior neurological staff through clinical and testing diagnostic procedures. Results. Among 48 recruited subjects 45.8% suffered from neurological comorbidity. 97.9% of the subjects (N=47) had a psychiatric disorder according to the SCID I, most (93.8%) a depressive disorder. 46 out of 48 subjects had psychological distress levels above the cut-off (≥12) at the K10, with a mean score of 21.4 (ds: 7.17). As regards people affected by depressive disorders, the K10 mean score was higher -but not statistically significant- among comorbid subjects (22.8; ds:8.1) than in those suffering only from an affective disorder (21.7; ds: 5.3) The subgroups significantly differed on the mean scores at the Global Assessment of Functioning Scale (GAF), assessing psychological, social and occupational functioning. Conclusions. Although neurological comorbidity was associated with a worse GAF, such an association was not found for psychological distress, as measured by K10. K10 could thus be used as outcome measure for depressive illness but also for psychological and pharmacological treatments, helpfully complementing symptoms remission measures for depressed inpatients.