Background. Depression is under-diagnosed and under-treated in the primary care sector. The purpose of this study was to determine the association between self-reported indications of depression by community- dwelling elderly enrollees in a managed care organization and clinical detection of depression by primary care clinicians. Methods. This was a 2- year cohort study of elderly people (n = 3410) who responded to the Geriatric Depression Scale (GDS) at the midpoint of the study period. A broad measure of clinical detection was used consisting of one or more of three indicators: diagnosis of depression, visit to a mental health specialist, or antidepressant medication treatment. Results. Approximately half of the community-based elderly people with self-reported indications of depression (GDS ≤ 11) did not have documentation of clinical detection of depression by health providers. PhySician recognition of depression tended to increase with the severity of enrollees' self-reported feelings of depression. Men 65-74 years old and those ≤85 years old were at highest risk for under-detection of depression by primary care providers. Conclusions. Clinical detection of depression of elderly people living in the community continues to be a problem. The implications of failure to recognize the possibility of depression among elderly White men suggest a serious public health problem.
|Journals of Gerontology - Series A Biological Sciences and Medical Sciences
|Published - 1998
ASJC Scopus subject areas
- Geriatrics and Gerontology