Prevalence and recognition of depressive disorders among Chinese older adults receiving primary care: A multi-center cross-sectional study

• Published in: Journal of affective disorders 2020-01, Vol.260, p.26-31
• Main Authors: Zhong, Bao-Liang, Ruan, Yi-Fan, Xu, Yan-Min, Chen, Wen-Cai, Liu, Ling-Fei
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Asian Continental Ancestry Group - psychology; Asian Continental Ancestry Group - statistics & numerical data; China; China - epidemiology; Cross-Sectional Studies; Depressive Disorder - epidemiology; Depressive Disorder - psychology; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Depressive disorders; Diagnostic and Statistical Manual of Mental Disorders; Dysthymic Disorder - epidemiology; Dysthymic Disorder - psychology; Female; Health Services for the Aged - statistics & numerical data; Humans; Logistic Models; Male; Mental Health Services - statistics & numerical data; Older adults; Prevalence; Primary care; Primary Health Care - methods; Primary Health Care - statistics & numerical data; Psychiatric Status Rating Scales
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2019.09.011

•The epidemiology of depressive disorders was examined among Chinese older adults receiving primary care.•One-fifth of the older adults (20.3%) had depressive disorders but only 1.3% of the depressed older adults were recognized by primary care physicians.•Female gender, poor financial status, loneliness, hypertension, heart disease, chronic gastric ulcer, and arthritis were significant factors associated with depressive disorders. In recent years, there have been increasing calls for integrating late-life mental health services into primary care in China, but data on the epidemiology of depressive disorders in older adults receiving primary care are very limited. This study examined prevalence, correlates and recognition of depressive disorders among Chinese older adults receiving primary care. A total of 752 older patients (65+ years) were consecutively recruited from 13 primary care clinics in Wuhan, China, and interviewed with the Chinese Mini-international Neuropsychiatric Interview 5.0. One–fifth (20.3%) of the older adults met DSM-IV criteria for depressive disorders during the month prior to the interview: 10.2% had major depression, 4.8% had dysthymia, and 5.3% had minor depressive disorder. The recognition rate of older patients with depressive disorders was 1.3% only. In multiple logistic regression analysis, factors significantly associated with depressive disorders included female gender (OR = 1.61), an education of primary school and below (OR = 1.69), poor financial status (OR = 2.44), poor or fair family relationship (OR = 1.66), loneliness (OR = 1.77), hypertension (OR = 1.91), heart disease (OR = 2.02), chronic gastric ulcer (OR = 6.01), and arthritis (OR = 3.55). Older adults from primary care clinics of economically underdeveloped regions of China were not included. Depressive disorders are prevalent but poorly recognized in Chinese older adults receiving treatment in primary care clinics. In order to improve the emotional well-being and health of older adults, it is time to integrate the management of common mental disorders into primary healthcare in China.