It is common for medical inpatients to manifest depressive symptoms, however diagnosing depression in them is a complicated problem and its evaluation and treatment remain one of the most difficult tasks for the psychiatrist. There have been several reports that Koreans tend to present with physical complaints as the primary symptom of depression and tend to visit department of Internal Medicine. The authors studied depressive symptoms am ong 150 Korean medical inpatients through the use of the Beck Depression Inventory (B D I), the Ham ilton Rating Scale for Depression (HRSD ) and the DSM-III-R diagnostic criteria. The results were as follows; 1) Demographic and medical variables were evaluated for relationship to depression for age 40，s and for educational level with no more than elementary graduated were statistically more depressed, but depression was not associated with sex, marital status, duration of hospitalization, or medical diagnosis. 2) 76 of the sample(50.6%) met DSM-III-R criteria for depression : 53 with dysthymia(35.3%) and 23 with major depression(15.3 %). 78(52.0%) had scores on the 17-item clinician-rated H R SD greater than the cutting score of 22. 63(46.0%) had scores on the BDI greater than the cutting score of 21. 3) Concordance for depression between DSM -III-R and BDI was 72%, but DSM-III-R and HRSD was 92%. 4) Screening ability for depressed group an d assessing ability for severity of depression by BDI and HRSD was studied BDI only screened between depressed and nondepressed group, but HRSD sensitively assessed severity of depression as well as screening of depressed group. Our study indicates that depressive symptoms may be common phenom enain medical inpatients and BDI and HRSD are useful screening instruments for them. However we propose to develop a formulation of depression that is based on observations of medical, not psychiatric patients
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