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

Neuropsychiatr Dis Treat. 2025 Apr 26:21:955-964. doi: 10.2147/NDT.S503053. eCollection 2025.

Abstract

Objective: 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: BSI-53; HADS-D; anxiety; depression; neurology; psychiatry.