Objectives: In a context of a "continuity of care" model in Psychosomatic and Liaison Psychiatry, this study is intended to test, in patients to be discharged from Medicine wards, hypotheses related to a high prevalence of depression and, in particular, its negative outcome at six-months follow-up in Primary Care (PC), specially among the elderly. Methods:Sample. Consecutive patients aged 18 years or more, hospitalized in Medicine wards were randomly selected for screening at the time of admission. On the bases of a previous study and the expected sampling errors, sample size was estimated in 700 patients (approximately 60% in geriatric age) for the initial screening, to recruit 75 or more cases of depression and enough number of control, non-cases without psychiatric morbidity. Instruments. Standardized, Spanish versions of screening/case-finding instruments COMPRI/INTERMED, Mini-Mental, CAGE and drug screening, Hospital Anxiety and Depression Scale (HADS). Standardized Polyvalent Psychiatric Interview (SPPI). Diagnostic criteria ICD-10 research, medical patients version and DSM-IV-TR (psychiatric); and ICD-9-M, ICHPPC, WONCA (medical). Cumulative Illness Rating Scale (CIRS) (severity of physical condition); SF36 and EuroQol (quality of life); Client Service Receipt Interview (CSRI) (costs). Procedure. Part I, hospital study: Two-phase screening (lay interviewers: COMPRI/INTERMED at admission; Mini-Mental, CAGE, HADS at the time of discharge: and standardized clinicians: SPPI). CIRS was used to control severity of physical conditions. Part H, follow-up study in PC (six months): Standardized clinicians, blind to the previous phases (HADS and SPPI to both cases and controls). Outcome study: EuroQuol SF36. CSRI and data on morbidity and mortality, were collected. Conclusions. To our knowledge, this is the first study using modern epidemiological methods in medical patients to be discharged with co-morbid depression and followed in PC with a "continuity of care" strategy. The final analysis of data should support the design of an evidence-based, intervention Study on co-morbid depression.
