Detection and treatment of major depression in patients with somatic illnesses admitted to the general hospital

Depression is a common disorder in patients with somatic illnesses admitted to
the general hospital. It has been demonstrated to have a negative influence on
treatment outcome in terms of somatic symptoms, functional impairment and
cost-effectiveness.

The aim of the study is to:
1. assess the prevalence of depression in patients with somatic illnesses
admitted to the general hospital and to examine which self-report questionnaire
is most suitable to screen for depression in this setting;
2. to examine whether depression has a negative influence on outcome in terms
of somatic symptoms and functional impairment;
3. to examine the effectiveness of cognitive behavioural therapy for depression
in patients with somatic illnesses.

Prospective study of a consecutive sample of patients admitted to the general
medical ward of a general hospital. Patients will be asked to complete several
screening instruments. All patients scoring above the cut-off level and a
random sample of those below will be invited to take part in a standardized
psychiatric interview.

Patients diagnosed as having a depression will be randomly assigned to cogntive
behavioural therapy or treatment as usual. Both patients participating in the
trial and a random sample of those who are not, will be followed up for a
period of 9 months with assessments at 3 months, 6 months and 9 months.

Cognitive behavioural therapy for depression in patients with somatic
illnesses.

Participation in the study does not pose any risks to the patients involved.
Patients randomized to the intervention condition might benefit from
psychological treatment of their depressive symptoms.