Documented Evidence of Depression in Medical and Nursing Case-Notes and Its Implications in Acutely Ill Geriatric Inpatients

Abstract

Depression is common among acutely ill elderly medical inpatients. Identification of such depression by the geriatric medicine staff would allow early treatment. The impact of a depression screening procedure on documentation of depressive signs and symptoms in the medical and nursing case-notes was examined. Thirty-five sets of medical and nursing case-notes of medically ill elderly inpatients, for whom data from the Brief Assessment Schedule and the short Geriatric Depression Scale (GDS) were also available, were examined for documentation of signs and symptoms of depression, prescription of antidepressants, and referred to the psychogeriatric service. Depressive signs and symptoms were documented in only a few medical (29%) and nursing (11%) case-notes. Only a small number of depressed patients were prescribed antidepressants (20%) or were referred to the psychogeriatric service (13%). The frequency of documentation of depressive signs and symptoms after the screening procedure with the short GDS was associated with subsequent prescription of antidepressants and referral to the psychogeriatric service. The screening procedure itself may increase the general awareness of depressive signs and symptoms and affect its management. These results require replication.