title: Psychiatric consultation in the nursing home: referral patterns and recognition of depression.
abstract: OBJECTIVE
  To assess the accuracy of referrals to psychiatric consultants for depression (or depression-related disorders) among nursing home residents.
  
  
  METHODS
  Retrospective review of psychiatric consultations for nursing home residents in six facilities for a 3-year period. Reasons for referral, assigned diagnoses, rates of accuracy, sensitivity and specificity were examined to assess patterns of referral and recognition of clinical variants of depressive disorders.
  
  
  RESULTS
  Referrals for depression comprised 19.7% of all requested consultations. Of patients referred for depression, 74.2% were diagnosed with a depressive disorder. Of all residents diagnosed with depressive disorders, 53.5% were referred for other reasons. Men were referred for evaluation of depression significantly more often than women. However, rates of diagnosis of depression did not appear to differ significantly between men and women.
  
  
  CONCLUSIONS
  Nursing home staff often failed to recognize depression. Depressed residents are primarily referred for disruptive behaviors. Referrals for depression may be a secondary concern.
authors.affiliation: Department of Psychiatry, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215, USA.
authors.forename: Raphael J
authors.initials: RJ
authors.lastname: Leo
authors.forename: Constance
authors.initials: C
authors.lastname: Sherry
authors.forename: Stacey
authors.initials: S
authors.lastname: DiMartino
authors.forename: Jurgis
authors.initials: J
authors.lastname: Karuza
mesh_terms: D000368:Aged; D000374:Aggression; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D005852:Geriatric Psychiatry; D006282:Health Personnel; D006801:Humans; D008297:Male; D009735:Nursing Homes; D012017:Referral and Consultation; D012189:Retrospective Studies