Recognition of Depression in the Elderly: A Comparison of General Practitioner Opinions and the Geriatric Depression Scale

Abstract

As part of a larger study, 133 subjects aged 70 years and over were screened for depression using the Geriatric Depression Scale, a 30-item questionnaire, as the screening instrument. Cognitive status was assessed using the Mini Mental State Examination. The subject's own general practitioner was asked his/her opinion as to whether the subject was depressed. Poor agreement was found between depression as measured by the Geriatric Depression Scale and the general practitioner's assessment. Possible reasons for this include the difficulty of finding a satisfactory operational definition of depression for use by general practitioners, the problems of identifying depression in the elderly, the arbitrary definition provided by the scale and the confounding of depression, as measured by the scale, with cognitive status.

Do Primary Care Physicians Have Particular Difficulty Identifying Late-Life Depression? A Meta-Analysis Stratified by Age

“…Nineteen studies recruited older patients and examined defined late-life depression, but of these only 12 considered both sensitivity and specificity [34,35,36,37,38,39,40,41,42,43,44,45]. Twenty-seven recruited younger adults and of these 12 examined both sensitivity and specificity [46,47,48,49,50,51,52,53,54,55,56].…”

“…The median number of depressed patients per study was 293.5 (SD = 750.2). The criterion methods of establishing depression consisted of a structured or semi-structured interview in 13 studies [34,35,36,37,38,39,46,47,48,49,50,57,58] and severity scales in 18 [40,41,42,43,44,45,51,52,53,54,55,56,59,60,61,62,63]. Of the 13 interview methods, 5 used a DSM-based definition of depression, 6 an ICD-10 definition, 1 the Schedule for Affective Disorder and Schizophrenia and 1 the Short Comprehensive Assessment and Referral Evaluation Interview.…”

Detection of depression in elderly hospitalized patients in emergency wards in France using the CES-D and the mini-GDS: preliminary experiences

“…The two scales CES-D and mini-GDS were used in a rater-administered form. In this population self-rating forms have several drawbacks, including ease of concealment, diculty of comparing oneself with others and the eects of literacy and lack of concentration (Pond et al, 1990). There was good agreement in identifying those likely to be depressed between the CES-D and the mini-GDS.…”

Evaluation of the Mental Healthiness Aging Initiative: Community Program to Promote Awareness About Mental Health and Aging Issues

“…The training consisted of three keys components: facts and information, application exercises, and community tools. The facts and information sections included information and discussion about the signs and symptoms of MH/SA disorders, suggestions for promoting good mental health, and strategies for the management of MH/SA disorders that came from current scientific literature in geriatric mental health, focused on the most prevalent disorders: depressive and alcohol disorders (Bartels et al 2005;Beyer 2007;Blow 2004, Blazer et al 2004Cockerham et al 1988;Dufour et al 1992;Fillmore and Weafer 2004;Lemke and Moos 2003;Liberto et al 1992;Community Ment Health J (2012) 48:193-201 195 Mackel et al 1994Ohayon 2007;Oslin 2004;Pond et al 1990;Skultety and Zeiss 2006;SAMSHA 2003;US Preventive Services Task Force 2004;Zanjani and Oslin 2006). The application exercise section included the description and implementation of a community action plan entitled PALS-Pay attention, Ask Questions, Listen actively, and Show support, for use when identifying possible MH/SA symptoms in community residents.…”

“…The MHAI intervention program is important because mental health and substance abuse (MH/SA) can be detrimental to elder adults, but often goes unrecognized (Pond et al 1990;Mackel et al 1994) and is frequently misrepresented as a normal part of aging (SAMSHA 2003). Depression affects approximately 14.8 million US adults (6.7 percent) in a given year (Kessler et al 2005), with approximately 27% of community residing adults over the age of 60 reporting depressive symptoms (Blazer et al 1987) and up to 50 percent of elder adults in rural areas meeting criteria for depressive disorders (Fisher and Copenhaver 2006).…”