General practitioners' assessments of mood concurred with ICD-10 research diagnoses in 66% of mild and 88% of moderate or severe depressive episodes in elderly patients.
Cross-Sectional (n=1,021)
Yes
How accurately do general practitioners recognize major depression in elderly patients compared to structured research interviews?
While general practitioners recognize moderate to severe depression well in elderly patients, they miss many specific symptoms and have high false positive rates, suggesting a need for symptom checklists.
BACKGROUND: It is important that serious depressive illness be recognized and treated appropriately by primary care practitioners. This and the preceding article in this issue examine (a) factors responsible for older patients' decision to report depressive symptoms to their doctor and (b) general practitioners' (GPs') recognition of depression when it was present. METHODS: A survey was conducted of a stratified sample of 1,021 patients aged 70+ years of 30 GPs in Melbourne, Australia, using the Canberra Interview for the Elderly, which generates rigorous ICD-10 research diagnoses. RESULTS: GPs' ratings of depression were best predicted in descending order of importance by patients' past contact with a psychiatrist, the doctor's view that a patient did not have dementia, the number of current depressive symptoms, patients' disclosure of these symptoms, and current physical pain. Physicians' assessments of patients' mood concurred with research diagnoses in 23 of 35 (66%) cases of ICD-10 mild depressive episode and 23 of 26 (88%) cases of moderate or severe depressive episode. GPs were unaware, however, of many depressive symptoms and often rated patients as being depressed when they were not. CONCLUSION: The use of a simple checklist of depressive symptoms would lead to a dramatic improvement in doctors' knowledge of patients' current psychiatric status.
O’Connor et al. (2001) conducted a cross-sectional in Major Depression (n=1,021). General practitioners' assessment vs. ICD-10 research diagnoses was evaluated on Concurrence of GPs' assessments of patients' mood with ICD-10 research diagnoses. General practitioners' assessments of mood concurred with ICD-10 research diagnoses in 66% of mild and 88% of moderate or severe depressive episodes in elderly patients.