Management of depression in elderly general practice patients

Abstract

Objective -To describe general practitioners' (GP) management (i.e., recognition and treatment) of depression in elderly patients.Design -Two separate studies were performed: (a) to study recognition of depression, a postal survey was sent to GPs; (b) to evaluate the consistency of treatment, patients considered depressed by GPs were described.Setting -general practices in the West of The Netherlands. Subjects -65 GPs, and 44 patients of 7 GPs. Main outcome meusures -(a) degree of recognition of depression as described in major depression case-vignettes (b) consistency of treatment.Results -(a) On average 65% of the GPs recognized every depressive symptom in case-vignette one, while 52% of GPs recognized each symptom in case two. Most (39) doctors used a time criterion of less than 5 weeks for depressive disorder. (b) Depressed patients with at least three depressive symptoms all received treatment. Chronically depressed patients appeared to be treated somewhat inadequately. Conclusion -The results suggest some inadequate knowledge of criteria for major depression and some inconsistency in treatment. The management of depression in elderly GP patients appears to need improvement.

Caring for Depressed and Suicidal Older Patients: A Survey of Physicians and Nurse Practitioners

“…Despite these trends, many researchers contend that older adults are inadequately assessed for depression while under the care of primary care providers [7,10,[17][18][19][20]. Mann [21] estimated that of the approximately six million depressed older adults in the United States, only one million will be diagnosed and treated properly.…”