Clinical Detection of Depression Among Community-Based Elderly People With Self-Reported Symptoms of Depression

Background. Depression is under-diagnosed and under-treated in the primary care sector. The purpose of this study was to determine the association between self-reported indications of depression by community-dwelling elderly enrollees in a managed care organization and clinical detection of depressi...

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Bibliographic Details
Published in:The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 1998-03, Vol.53A (2), p.M92-M101
Main Authors: Garrard, Judith, Rolnick, Sharon Judith, Nitz, Nicole M., Luepke, Lori, Jackson, Jody, Fischer, Lucy Rose, Leibson, Cynthia, Bland, Patricia C., Heinrich, Richard, Waller, Lance A.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging - psychology
Cohort Studies
Community Medicine - methods
Depression - diagnosis
Depression - psychology
Female
Humans
Male
Medical diagnosis
Mental depression
Older people
Physicians
Self-Assessment
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Summary:Background. Depression is under-diagnosed and under-treated in the primary care sector. The purpose of this study was to determine the association between self-reported indications of depression by community-dwelling elderly enrollees in a managed care organization and clinical detection of depression by primary care clinicians. Methods. This was a 2-year cohort study of elderly people (n = 3410) who responded to the Geriatric Depression Scale (GDS) at the midpoint of the study period. A broad measure of clinical detection was used consisting of one or more of three indicators: diagnosis of depression, visit to a mental health specialist, or antidepressant medication treatment. Results. Approximately half of the community-based elderly people with self-reported indications of depression (GDS ≥ 11) did not have documentation of clinical detection of depression by health providers. Physician recognition of depression tended to increase with the severity of enrollees' self-reported feelings of depression. Men 65–74 years old and those ≥85 years old were at highest risk for under-detection of depression by primary care providers. Conclusions. Clinical detection of depression of elderly people living in the community continues to be a problem. The implications of failure to recognize the possibility of depression among elderly White men suggest a serious public health problem.
ISSN:1079-5006
1758-535X
DOI:10.1093/gerona/53A.2.M92