Life experience of hospitalized adolescents associated with identified levels of depression

Hospitalization is considered to be a particularly stressful experience for the adolescent who is undergoing both physical and psychological developmental changes. Hospitalized adolescents may, therefore, experience depression and anxiety when separated from family and friends because of illness. As suicide has emerged as one of the leading causes of death among teenagers, suicide prevention for persons in this age group has become of the utmost importance. Since depression has been shown to be significant predictor of suicidal behavior, hospitalized adolescents can be considered a probable high risk population. The adolescent, however, often "masks" his depression with other behaviors making it difficult to detect. Hospital personnel may therefore not be aware of the suicidal danger and the need for preventive measures. Nurse, in continuous contact with the adolescent at this stressful time, can take a primary role in the identification of depression which may be indicative of suicidal potential, institute preventive measure and work to alleviate the depression. The primary purpose of this exploratory study was to substantiate the existence of depression in adolescents who have been separated from family and friends by admission to a general hospital. For this purpose, the Beck Depression Inventory (DI) and a slightly modified version of the Zung Self-Rating Depression Scale were administered to a sample of 32 adolescents admitted to the University Hospital of the University of Utah Medical Center, Salt Lake City, Utah. They ranged in age from 14 to 20. For purpose of comparison one-half of the subjects were selected from the medical and surgical units and one-half from the psychiatric unit. A personal data sheet consisting primarily of factors usually shown to be associated with suicidal behavior in the adolescent was also give, for the purpose of identifying the life experiences associated with depression in this age group. In order to determine the relationship between anxiety and depression in this study and to observe for fluctuations in anxiety levels over the first 48 hours of hospitalization, two equivalent forms of the IPAT 8-Parallel-Form-Anxiety Battery were administer within 24 and 48 hours of admission. Mean scores on both the Beck Depression Inventory (DI) and the Zung Self-Rating Depression Scale (SDS) were indicative of depression in the total sample. The two depression measures were shown to correlate highly in this study (r = .70, p < .001). The psychiatric group was found to be more depressed than those adolescents hospitalized on the medical and surgical units. Many of the life experiences found to be significantly related to levels of depression were included in those found in the relevant literature to be associated with suicidal behavior among adolescents. The significant variables were largely related to factors of social isolation and separations. This study concluded that the depression level of the hospitalized adolescent may be predicted by use of knowledge of the adolescent's current life situation and life history. Mean scores for the sample on Forms A and B of the IPAT 8-Parrallel-Form Anxiety Battery fell within the normal range of scores. The scores on the IPAT Form A were somewhat higher than those on Form B, indicating more anxiety during the initial 24 hours after admission, than during the following 24 hours which was the time that Form B was administered. As an exploratory study, this investigation was limited by a small sample size and the use of few controls. The need for further study of depression in the hospitalized adolescent is indicated.