Medical morbidity and severity of depression in a large primary care sample of older Australians: the DEPS‐GP project

Abstract

Objectives: To estimate the prevalence of depression among older Australians with common medical morbidities, and to determine the association between poor physical health and depression in this age group. Design: Cross‐sectional, postal questionnaire survey. Setting and participants: 20 183 community‐dwelling adults aged 60 years and over, under the care of 383 general practitioners participating in the Depression and Early Prevention of Suicide in General Practice (DEPS‐GP) project (conducted between 2005 and 2008; the data in this article were collected during the baseline phase of the study in 2005). Main outcome measures: Depressive symptoms (measured by the nine‐item depression scale of the Patient Health Questionnaire), health status (measured by the 12‐item Short Form Health Survey and a medical morbidity inventory), social support (measured by the subjective support subscale from the Duke Social Support Index), and demographic and lifestyle information. Results: 18 190 participants (90.1%) reported having at least one chronic physical health condition, while 1493 (7.1%) experienced clinically significant depression (3.1% major depressive syndrome; 4.0% other depressive syndrome). Most chronic physical illnesses were associated with increased odds of depression, and participants with numerous medical morbidities and a high level of functional impairment were three to four times more likely to have a depressive illness. Conclusions: Depression is more the exception than the rule in later life, and among those who are medically unwell, the level of associated impairment may determine their risk of depression more than their acquired physical illness. Many of the factors associated with depression in medically ill patients are amenable to treatment, and GPs are in a unique position to address this important public health issue.

Is there scope for community health nurses to address lifestyle risk factors? the community nursing SNAP trial

“…These baseline findings suggest however that intervening with this group is not going to be easy because of their age and associated co-morbidities, with almost half having three or more conditions. Participants were also more than twice as likely to report suffering from depression, compared to those in the 2007 National Survey of Mental Health and Wellbeing [31,32]. This is consistent with the finding that depression is a common co-morbidity with chronic disease conditions or multiple lifestyle risk factors [32,33].…”

Pain severity predicts depressive symptoms over and above individual illnesses and multimorbidity in older adults

“…In line with previous literature (e.g., [1, 2, 5–9]) we hypothesize that the number of illnesses experienced by older adults will be associated with increased depressive symptoms. Also in accordance with prior findings [13, 14] we hypothesize that the proportion of patients who report clinically significant depressive symptoms and at least moderate pain will be higher amongst those with multi-morbidity than those without.…”

“…Estimates of multi-morbidity indicate that over 75% of adults older than 75 years presenting to primary care services have two or more chronic illnesses [3]. There is a considerable literature that confirms that the presence of multi-morbidity is associated with increased depressive symptoms in older adults (e.g., [1, 2, 5–9]). Although relatively few studies have investigated the relationship between multi-morbidity and diagnosed depressive disorders, the research is consistent in indicating that multi-morbidity is associated with a greater risk of a depressive disorder (e.g., [10, 11]).…”

The B-VITAGE trial: A randomized trial of homocysteine lowering treatment of depression in later life

“…The Western Australian Centre for Health and Ageing have access to large databases of potential participants from previous studies (DEPS-GP, [33] n = 4305 and HIMS, [34] n ≈ 7500) and these will be utilized to aid recruitment. Participants from these studies who have indicated that they would be happy to have future contact with the Centre will be invited to participate.…”