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Old age medical patients screening positive for depression

Published online by Cambridge University Press:  13 June 2014

Adrian Mark Winrow
Affiliation:
Dewsbury and District Hospital, The Priestley Unit, Halifax Road, Dewsbury, West Yorkshire, WF13 4HS, England
John David Holmes
Affiliation:
Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, 15 Hyde Terrace, Leeds LS2 9LT, England

Abstract

Objective: The aim was to observe whether medical inpatients screening positive for depression using the Geriatric Depression Scale (GDS) continue to screen positive following hospital discharge.

Method: Participants aged 65 or over, were recruited from consecutive admissions to a city teaching hospital. Subjects had an Abbreviated Mental Test Score (AMTS) of seven or above and a GDS-15 score of five or above. Information was collected on past psychiatric history and living arrangements. Subjects were followed-up three months later and the GDS repeated.

Results: Thirty subjects were recruited and 26 (87%) followed-up. Ten (38%) no longer scored positive on the GDS, and overall the mean GDS score decreased by two points (Z = 2.235 p < 0.05). Patients with a past psychiatric history or living alone were more likely to be depressed at follow-up. No participants were referred to the psychiatric service or started on antidepressant medication during the course of the study.

Conclusion: Depressive symptoms are likely to persist following hospital discharge, especially in those patients with a past psychiatric history. An understanding of the risk factors associated with persistent depressive symptoms is necessary if the patients appropriate for treatment are to be identified.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2005

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References

1.Burn, WK, Davies, KN, McKenzie, FRet al.The prevalence of psychiatric illness in acute geriatric admissions. Int J Ger Psychiatry 1993; 8: 171–74.CrossRefGoogle Scholar
2.Jackson, R, Baldwin, R. Detecting depression in elderly medically ill patients: The use of the Geriatric Depression Scale compared with medical and nursing observations. Age Ageing 1993; 22: 349–53.CrossRefGoogle Scholar
3.Ramsay, R, Wright, P, Katz, Aet al.The detection of psychiatric morbidity and its effect on outcome in acute elderly medical admissions. Int J Geriatric Psychiatry 1991; 6: 861–66.CrossRefGoogle Scholar
4.Koenig, HG, George, LK, Larson, DBet al.Depressive symptoms and nine-year survival of 1001 male veterans hospitalised with medical illness. Am J Ger Psychiatry 1999; 7: 124–31.CrossRefGoogle Scholar
5.Saravay, SM, Lavin, M. Psychiatric co-morbidity and length of stay in the general hospital: A critical review of outcome studies. Psychosomatics 1994; 35: 233–52.CrossRefGoogle ScholarPubMed
6.Stoudmire, A, Thompson, TL. Medication non-compliance: Systematic approaches to evaluation and intervention. Gen Hosp Psychiatry 1983; 5: 233–39.CrossRefGoogle Scholar
7.Stuck, AE, Walthert, JM, Nikolaus, Tet al.Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci and Med 1999; 48: 445–69.CrossRefGoogle ScholarPubMed
8.Pomerantz, A, de Nesnera, A, West, A. Resolution of depressive symptoms in medical inpatients after discharge. Int J Psychiatry in Medicine 1992; 22(3): 281–9.CrossRefGoogle ScholarPubMed
9.Arnold, N, Kafetz, K. Elderly medical inpatients screening positive for depression may show spontaneous improvement after discharge. Age Ageing 2002; 31: 397400.CrossRefGoogle ScholarPubMed
10.Cole, MG, Bellavance, F. Depression in elderly medical inpatients: a meta-analysis of outcomes. Can Med Assoc J 1997; 157(8): 1055–60.Google ScholarPubMed
11.Tharpa, PB, Gideon, P, Cost, Tet al.Antidepressants and the risk of falls among nursing home residents. N Engl J Med 1998; 339(13): 875–82.CrossRefGoogle Scholar
12.Sheikh, JI, Yesavage, JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clin Gerontology 1986; 6: 165–73.Google Scholar
13.Hodkinson, HM. Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing 1972; 1: 233–8.CrossRefGoogle ScholarPubMed
14.Burvill, PW, Mowry, B, Hall, W. Quantification of physical illness in psychiatric research in the elderly. Int J Ger Psychiatry 1990; 5: 161–70.CrossRefGoogle Scholar
15.Wade, DT, Collin, C. The Barthel ADL Index: a standard measure of physical disability? Int Disability Studies 1988; 10: 64–7.CrossRefGoogle ScholarPubMed
16.Rapp, SR, Parisi, SA, Wallace, CE. Comorbid psychiatric disorders in elderly medical inpatients: A 1-year prospective study. J Am Ger Soc 1991; 39: 124131.CrossRefGoogle Scholar
17.Almeida, O, Almeida, S. Short versions of the geriatric depression scale: A study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. Int J Ger Psychiatry 1999; 14: 858–65.3.0.CO;2-8>CrossRefGoogle Scholar
18.Koenig, HG, Meador, KG, Shelp, Fet al.Major depressive in hospitalised medically ill patients: An examination of young and elderly male veterans. J Am Ger Soc 1991; 39: 881–90.CrossRefGoogle Scholar
19.Bowler, C, Boyle, A, Branford, M, Cooper, Set al.Detection of psychiatric disorders in elderly medical inpatients. Age Ageing 1994; 23: 307–11.CrossRefGoogle ScholarPubMed
20.Shah, A, De, T. Depression and anxiety in geriatric inpatients: Documented evidence of depression in medical and nursing case-notes and its implications in acutely ill geriatric inpatients. Int Psychogeriatr 1998; 10(2): 163–72.CrossRefGoogle Scholar
21.Pomeroy, IA, Clark, CR, Philp, I. The effectiveness of very short scales for depression screening in elderly medical patients. Int J Ger Psychiatry 2001; 16: 321–6.CrossRefGoogle ScholarPubMed