Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-15T05:20:11.720Z Has data issue: false hasContentIssue false

Screening for depression in hospitalised elderly medical patients

Published online by Cambridge University Press:  13 June 2014

Barbara Farragher
Affiliation:
Clondalkin Mental Health Service, Unit 1 A, The Village Centre, Orchard Road, Clondalkin, Dublin 22, Ireland
Joseph Duggan
Affiliation:
Departments of Psychiatry of Old Age and Medicine for the Elderly, James Connelly Memorial Hospital, Blanchardstown, Dublin 15, Ireland

Abstract

Objective: The aim of this study was to screen a group of medically ill elderly hospitalised patients for depression and to facilitate this using a new screening questionnaire called the Evans Liverpool Depression Rating Scale (ELDRS).

Method: The questionnaire was administered by a geriatric registrar to a consecutive series of 37 acutely ill elderly medical inpatients admitted to an acute hospital ward. They were subsequently interviewed by a member of the psychiatry of old age team.

Results: Seven of the 37 acutely ill elderly patients admitted to hospital were found to be suffering from a major depressive illness according to DSMIIIR criteria. Of the patients screened, two were already on antidepressant medication. Five of the depressed patients were identified by using the ELDRS. All of the depressed group were judged to require antidepressant medication and two were referred to a psychiatry of old age day hospital.

Conclusions: Our results suggest that there is a raised prevalence of depressive illness in elderly acutely ill medical patients which remains undetected. Use of a screening questionnaire such as the ELDRS would increase the likelihood of its identification in this group.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Koenig, HG, Meador, KG, Cohen, HJ, Blazer, DG. Depression in elderly hospitalised patients with medical illness. Arch Intern Med 1988; 148: 1929–36.CrossRefGoogle ScholarPubMed
2.O'Riordan, TG, Hayes, JP, Shelley, R, O'Neill, D, Walsh, JB, Coakley, D. The prevalence of depression in an acute geriatric medical unit. Int J Geriat Psychiatr 1989; 4: 1721.CrossRefGoogle Scholar
3.Rapp, SR, Parisi, SA, Walsh, DA. Psychological dysfunction and physical health among elderly medical inpatients. Clin Psychol 1988; 56: 851–5.Google ScholarPubMed
4.Kitchell, MA, Barnes, RF, Veith, RC, Okimoto, JT, Raskind, MA. Screening for depression in elderly hospitalized geriatric medical patients. J Am Geriat Soc 1982; 30: 174–7.CrossRefGoogle ScholarPubMed
5.Zung, WK. Recognition and treatment of depression in a family medicine practice. J Clin Psych 1983; 644: 3.Google Scholar
6.Koenig, HG, Meador, KM, Cohen, HG, Blazer, RD. Detection and treatment of major depression in older medically ill hospitalised patients. Int J Psychiatry Med 1988; 18: 1731.CrossRefGoogle Scholar
7.Fulop, G, Strain, J, Vita, J, Lyons, JS, Hammer, JS. Impact of psychiatric comorbidity on length of hospital stay for medical/surgical patients: a preliminary report. Am J Psychiatry 1987; 144: 878–82.Google ScholarPubMed
8.Murphy, E. The prognosis of depression in old age. Br J Psychiatry 1983; 142: 111–9.CrossRefGoogle ScholarPubMed
9.Gordon, WC. Elderly depressives: treatment and follow-up. Can J Psychiatry. 1981; 26: 110–3.CrossRefGoogle ScholarPubMed
10.Rapp, SR, Walsh, DA, Parisi, SA, Wallace, CE. Detecting depression in elderly medical inpatients. J Consult Clin Psychol 1988: 56; 509–13.CrossRefGoogle ScholarPubMed
11.Yesavage, SA, Brink, TL. Development and validation of a geriatric depression screening scale. A preliminary report. J Psychiatr Res 1983: 17; 3749.CrossRefGoogle Scholar
12.Finch, EJL, Ramsey, R, Katona, CLE. Depression and physical illness in the elderly. Clin Geriatr Med 1992: 8(2); 275–87.CrossRefGoogle ScholarPubMed
13.Burke, WJ, Houston, MJ, Boust, SJet al.Use of the Geriatric Depression Rating Scale in dementia of the Alzheimer type. J Am Geriatr Soc 1989; 37: 856–60.CrossRefGoogle ScholarPubMed
14.Evans, ME. Development and validation of a brief screening scale for depression in the elderly physically ill. Int Clin Psychopharmacol 1993; 8(4): 329–31.CrossRefGoogle ScholarPubMed
15.Copeland, JRM, Dewey, , Griffith-Jones, HM. A computerised psychiatric diagnostic system and case nomenclature for elderly subjects; GMS and AGECAT. Psychol Med 1986; 16:8999.CrossRefGoogle ScholarPubMed
16.Folstein, ME, Folstein, SE, McHugh, PR. Mini Mental State. A practical method for grading the cognitive state of patients for the clinicians. J Psychiatr Res 1975; 12: 189–98.CrossRefGoogle Scholar
17.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed, revised. Washington DC: 1987.Google Scholar
18.Copeland, JRM, Davidson, IA, Dewey, MEet al.Alzheimer's disease, other dementias depression and pseudodementia: prevalence, incidence and three year outcome in Liverpool. Br J Psychiatry 1992; 161: 230–9.CrossRefGoogle ScholarPubMed
19.Eastwood, MR, Corbin, SL. The relationship between physical illness and depression in old age. In: Murphy, E, ed. Affective Disorders in the Elderly. London: Churchill Livingstone, 1986.Google Scholar
20.Koenig, HG, Shelp, F, Goli, V, Cohen, HJ, Blazer, DG. Survival and health care utilisation in elderly medical inpatients with major depression. J Am Geriatr Soc 1989; 37: 599606.CrossRefGoogle Scholar
21.O'Riordan, T, Hayes, J, O'Neill, D, Shelley, R, Walsh, JB, Coakley, D. The effect of mild to moderate dementia on the Geriatric Depression Scale and the General Health Questionnaire in the hospitalised elderly. Age Ageing 1990; 19: 5761.CrossRefGoogle Scholar
22.Jones, BN, Reifler, BV. Depression coexisting with dementia. Evaluation and treatment. Med Clin North Am 1994; 78(4): 823–40.CrossRefGoogle ScholarPubMed
23.Reifler, BV, Larson, E, Cox, G. Treatment results at a multispeciality clinic for the impaired elderly and their families. J Am Geriatr Soc 1981; 29: 579–82.CrossRefGoogle Scholar
24.Koenig, HG, Kudler, HS, Cohen, HJ, Meador, KG, Blazer, DG. Antidepressant use in elderly medical inpatients: lessons learned from an attempted trial. J Gen Intern Med 1989: 4; 498505.CrossRefGoogle Scholar
25.Parkes, CM, Benjamin, B, Fitzgerald, RG. Broken heart: a statistical study of increased mortality among widowers. BMJ 1969; 1: 740.CrossRefGoogle Scholar
26.Evans, ME, Lye, M. Depression in the elderly physically ill: an open study of treatment with the 5-HT reuptake inhibitor fluoxetine. J Clin Experimental Gerontol 1992; 14(3&4): 297307.Google Scholar