Beyond Anxiety and Depression: Multidimensional Psychiatric Screening for Neurological Patients Based on HADS and BSI-53

Milenko Kujovic,1,2 Daniel Benz,1,2 Bruno Baumann,3 Christina Engelke,2 Zsofia Margittai,1 Julia Christl,1 Rüdiger J Seitz,2 Til Menge,2 Christian Bahr,1,2 Mathias Riesbeck,1 Eva Meisenzahl,1 Christian Schmidt-Kraepelin1,4 1Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; 2Centre for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; 3Department of Psychiatry, University Hospital Münster, University of Münster, Münster, Germany; 4Department of Psychiatry and Psychotherapy, Kaiserswerther Diakonie, Florence Nightingale Hospital, Düsseldorf, GermanyCorrespondence: Daniel Benz, Email [email protected]: Although neurological patients are known to suffer from psychiatric comorbidities, appropriate, cost-effective, standardized screening measures are still scarce in clinical practice. We examined a multidimensional psychiatric screening for neurological patients.Methods: We report a retrospective analysis of multidimensional psychiatric screening using the HADS-D and the BSI-53 in 437 consecutive neurological inpatients. The HADS-D describes depressive and anxiety symptoms, while the BSI-53 expands the symptom clusters associated with psychiatric disorders by somatization, obsessive-compulsion, interpersonal sensitivity, hostility, paranoid ideation, psychoticism and global measures of mental distress. Patients were separated in diagnostic groups (vascular, demyelinating, degenerative, epileptic, other) with regard to their diagnosis.Results: Our results corroborate previous findings of high prevalence of psychiatric symptoms particularly in younger patients (< 60 years). Furthermore, 27.2% were above the HADS-D cut-off for anxiety and 25.4% for depression. We found no differences between diagnostic groups. Importantly, we also show that neurological patients suffer from mental distress beyond anxiety and depression, around 16– 30% depending on age and gender.Conclusion: We have shown that a notable proportion of neurological patients report psychiatric symptoms, thus emphasizing the importance of a thorough, multidimensional psychiatric screening in neurological patients.Trial Registration Number: DRKS00030528, date of registration: 2022-11-04 retrospectively registered.Keywords: psychiatry, neurology, BSI-53, HADS-D, depression, anxiety