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  • Title: Recognition of depression in older medical inpatients discharged to ambulatory care settings: a longitudinal study.
    Author: McCusker J, Cole M, Latimer E, Sewitch M, Ciampi A, Cepoiu M, Belzile E.
    Journal: Gen Hosp Psychiatry; 2008; 30(3):245-51. PubMed ID: 18433656.
    Abstract:
    OBJECTIVE: This study aimed to examine the recognition of depression in older medical inpatients by nonpsychiatric physicians over a 2-year period. METHODS: A cohort of medical inpatients aged 65 and above was recruited at two university-affiliated hospitals, with oversampling of depressed patients. Participants were assessed with research diagnoses of major or minor depression (DSM-IV) at admission and at 3, 6 and 12 months. Indicators of recognition during the 12 months before and the 12 months after admission, derived from administrative databases, included the following: depression diagnosis, antidepressant prescription and psychiatric referral. Multiple logistic regression analyses were used to identify factors associated with recognition. RESULTS: Among 185 patients with at least one research diagnosis of depression during the study, recognition rates ranged up to 56% during the 12 months before admission among patients with major depression lasting at least 6 months and up to 61% during the 12 months after admission among patients with persistent major depression. In both study periods, a greater number of physician visits and prescription of a psychotropic medication (non-antidepressant) were independently associated with recognition. CONCLUSIONS: A longitudinal approach to measuring recognition of late-life depression in ambulatory care settings indicates that persistent major depression is more likely to be recognized than previously reported.
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