Recovery of patients with severe depression in inpatient rural psychiatry: a descriptive clinical study

Abstract

Objectives: The aim of this study was to investigate the level of and the relationship between symptoms and health-related quality of life (HRQoL) at admittance and recovery at discharge in patients with severe depression, in a rural inpatient psychiatric setting. Furthermore, whether the anxiety level at admission and/or, if the extent of patients’ perception of family support from professionals were related to recovery.

Method: Patients admitted with depression were consecutively invited to participate during a 12-month period. Depression, anxiety and stress were measured with DASS (The Depression Anxiety Stress Scale) and HRQoL with The Icelandic Quality of Life scale at admission and discharge. Family support was measured with Icelandic Family Perceived Support Questionnaire at discharge.

Results: Majority of the participants had severe depression and anxiety scores (93.8% and 76.9%, respectively) at admission and HRQoL was impaired, especially in men. At discharge, almost three quarters of the participants had recovered into the outpatient or functional symptoms level and HRQoL had increased significantly. Morbid anxiety delayed recovery significantly, but perceived cognitive family support was positively related to depression recovery.

Conclusion: Hospitalisation is an effective intervention for severe depression in rural Iceland. Positive benefits in both depression and HRQoL occur, where most of the participants reach outpatient or normal level of depression.

Keywords:

• Anxiety
• depression
• family support
• health-related quality of life
• recovery

Acknowledgements

The authors thank the participants for their important contribution to science. Patients were willing to participate; some of them mentioned they wanted the study to be beneficial to others. It is admirable that patients with severe mental illness are willing to participate in research. The authors also thank the clinical nurses and the nurse assistants at the acute psychiatric unit at Akureyri Hospital, who did well following the research plan and data gathering. Appreciation is expressed to Merrie J. Kaas, PhD, APRN, PMHCNS-BC, FAAN, Professor at the School of Nursing at the University of Minnesota, USA for her kind assistance in proofreading the manuscript.

Ethical policy and institutional review board statement

Ethical approval for this study was obtained from the Health Research Ethical Committee at Akureyri Hospital (8/2013) and the study was reported to the Data Protection Committee in Iceland (S6541/2013). The approval of the Medical Director and Director of Nursing at Akureyri Hospital was received as well.

Author contributions

SOG, EKS and RHA designed the study and were responsible for obtaining approvals of the study. SOG was responsible for collecting the data, with supervision from RHA and EKS. SOG, RHA and EKS were responsible for analysing and interpreting the data. SOG wrote the first draft of this article. RHA, EKS and SOG edited the manuscript together before submitting it for publication.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors of this paper confirm that database for this study does not belong to a collective database. The data were specifically collected for this study and approved accordingly by ethical committees. Data can be made available from first author on reasonable request.

Additional information

Funding

This work was supported by the Scientific Fund for the Nurse Association in Iceland, and the Science fund of Akureyri Hospital.

This work was supported by the Scientific Fund for the Nurse Association in Iceland, and the Science fund of Akureyri Hospital.

Notes on contributors

Snaebjorn Omar Gudjonsson

Snaebjorn Omar Gudjonsson, RN, MSc is a clinical nurse specialist (CNS) working at the department of psychiatry of Akureyri Hospital. Coordinator of Calgary family nursing implementation at Akureyri Hospital. Coordinator of multifamily group therapy implementation at the oupatient department of psychiatry at Akureyri Hospital. Temporary lecturer at the University of Akureyri.

Eydis Kristin Sveinbjarnardottir

Eydis Kristin Sveinbjarnardottir, RN, MSN, PhD, is dean and associate professor at the School of Health Sciences at the University of Akureyri. Her research emphasis is on implementation of family nursing and brief family support, for carers and children of ill parents, into routine clinical practice in psychiatry and health care.

Ragnheidur Harpa Arnardottir

Ragnheidur Harpa Arnardottir, PT, PhD, is associated professor in Health Sciences at the University of Akureyri and is also a physiotherapist at the rehabilitation department of Akureyri Hospital. Her research is mainly in the field of pulmonary diseases, with emphasis on physical function, mental health and health-related quality of life.