Depression is the most common mental disease in patients hospitalized with physical illness. Disorders of anxiety and depression in general hospitals are frequently underdiagnosed and inappropriately treated. Our objective was to assess the prevalence of undiagnosed anxiety and depression in surgical inpatients and assess the referral rate and utilization of liaison psychiatry services.

A prospective multi-centre study of surgical admissions (n=96) to two surgical services at two separate institutions between 1/01/05 and 31/12/05. The surgical services included general surgery and cardiothoracic surgery. Data was collected prospectively utilizing the computerized hospital inpatient system (HIS) and supplemented with data from medical records. The Hospital Anxiety and Depression (HAD) scale was used to evaluate all patients in the study cohort. Patients with a documented psychiatric history and established psychiatric diagnosis were excluded.

We had 96 individuals in our patient cohort. The mean age was 59.6 years. There was a slight female predominance with a female: male ratio of 1.18:1. Surgical procedures were performed in 68.75% of our patient cohort. 12.5% of patients were discovered to suffer with significant depression. 18.75% of patients suffered with significant anxiety. 8.3% of patients had significant mixed anxiety and depression. 22.9% of patients warranted referral to liaison psychiatry services for further assessment and management.

Disorders of anxiety and depression are highly prevalent in surgical inpatients. There needs to be an increased awareness of the possibility of undiagnosed psychiatric disorders in such patients along with prompt and appropriate use of liaison psychiatry services.