Correlates of unrecognized depression among hospitalized geriatric patients.
OBJECTIVE
The goal of this study was to assess the level and analyze the determinants of under-recognition of symptomatic depression by geriatricians in hospitalized geriatric patients.


METHODS
This was a prospective study of 155 patients who were consecutively hospitalized in the geriatric unit of an academic hospital. The diagnosis of symptomatic depression was established, in a parallel blinded manner either by one psychogeriatrician using a geriatric depression scale and the DSM-IV criteria for depression or by one geriatrician using a global assessment score included in a comorbidity index or by both.


RESULTS
The psychogeriatrician diagnosed symptomatic depression in 67 of the 155 patients (43%). In contrast, the geriatrician identified symptomatic depression in 29 (19%) of the 155 patients, one of whom was not diagnosed with depression by the psychogeriatrician. Thus the geriatrician failed to identify 39 patients who were diagnosed with depression by the psychogeriatrician.


CONCLUSIONS
In this study of hospitalized geriatric patients, a geriatrician failed to recognize more than half of those who were diagnosed with symptomatic depression by a psychogeriatrician. Uncontrolled comorbidity and therapeutics may be misleading factors in diagnosing depression. The presence of a psychogeriatrician in a geriatric unit could prevent underestimation of depressive symptoms among geriatric patients.
Pepersack
Thierry
T
Erasmus Hospital, Geriatrics, Lennik Street 808, 1070 Brussels, Belgium. tpepersa@ulb.ac.be
De Breucker
Sandra
S
Mekongo
Yves-Patrick Nkodo
YP
Rogiers
Anne
A
Beyer
Ingo
I
D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D003951:Diagnostic Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D015577:Geriatric Assessment; D005852:Geriatric Psychiatry; D005853:Geriatrics; D006760:Hospitalization; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011581:Psychological Tests; D016037:Single-Blind Method