Psychiatric consultation in the nursing home: referral patterns and recognition of depression.
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.
Leo
Raphael J
RJ
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.
Sherry
Constance
C
DiMartino
Stacey
S
Karuza
Jurgis
J
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