[Mini-GDS in elderly population administered by general practitioners].
Depression in the elderly is often unknown, underdiagnosed and undertreated. In primary care, there is a need to help this clinical challenge. The aim of this study is to show that a detection tool which is reliable, easy and rapid to use, the mini-GDS, could be an aid to detect depression in the elderly in general practice and to sensitize to treat these patients. A survey realized with 75 general practitioners permit to have data about 1,532 elderly patients. Three logistic regression analysis were done to assess effect of different variables on the dichotomized score of the mini-GDS, on the psychotropics prescription and on the diagnosis of depressive disorder. There was a depressive and/or anxious symptomatology (DAS) in 44% of cases. Some variables had an effect on the obtained mini-GDS score, but this score also seemed to influence psychotropics prescription (10% increase), even though an observed DAS did not indicate to this prescription. Other variables as a previous psychotropic treatment, a recent life event, or somatic complaints had an effect on this prescription. In antidepressants prescriptions, 94% agreed with a positive score on mini-GDS and 89% to a diagnosis of DAS, but in anxiolytics prescriptions, 79% agreed with a positive score on mini-GDS and 81% to a diagnosis of DAS. Finally, with cut-off score 1, a statistically significant correlation was observed between positivity and the presence of DAS (p < 0.0001), but also between positivity and psychotropics prescription (p < 0.0001) and more particularly with an antidepressant prescription (p < 0.0001). A post survey after one year with 30 practitioners who participated in this sensitization study showed that, within the 16 respondents, this kind of training had been helped them to better recognize depression (13/16) and modified their therapeutic attitude (9/16). This clinical approach should be more and more recommended to improve the still very bad prognosis of depression in the elderly.
Clément
J P
JP
SHU Psychiatrie, Centre Hospitalier Esquirol, 15, rue du Docteur Marcland, 87025 Limoges.
Preux
P M
PM
Fontanier
D
D
Léger
J M
JM
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011320:Primary Health Care; D011602:Psychophysiologic Disorders / Q000453:epidemiology / Q000209:etiology; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011795:Surveys and Questionnaires
D011619:Psychotropic Drugs