TITLE:
The prevalence of depression amongst outpatients with multimorbidity
AUTHORS:
Melinda Stanners, Christopher Barton, Sepehr Shakib, Helen Winefield
KEYWORDS:
Multimorbidity; Geriatric Depression Scale; Chronic Disease
JOURNAL NAME:
Health,
Vol.5 No.4,
April
24,
2013
ABSTRACT:
Objectives:
Depression may be under-diagnosed and under-treated amongst older adults with
multiple chronic illnesses. The current study explores the prevalence of depression
diagnosis and Geriatric Depression Scale (GDS) symptoms amongst older
multimorbid outpatients, and agreement between GDS scores and
doctor-diagnosed depression. Method: Deidentified data from the files of 452
patients aged over 64, with chronic conditions present in two or more organ
domains, were extracted from the clinical database of a tertiary referral
hospital multidisciplinary outpatient clinic in South Australia between 2005
and 2011. Frequency calculations determined the prevalence of depression
diagnosis and GDS categories. Logistic regression, cross-tabulation, kappa
and ROC graphs explored relationships between variables. Results: A
depression diagnosis had been recorded for 71 (15.7%) patients. Using the recommended cut-off scores for the GDS, 225 (49.8%) patients met criteria for
mild-severe depressive symptoms, and 96 (21.3%) met criteria for moderate-severe
symptoms. Poor agreement was found between doctor diagnosis of depression and a
positive screen for depression using a GDS cut-off score of either 5, k = 0.112
(p = 0.001), or 9, k = 0.189 (p severity, depression often goes undetected in this population.
Depressions’ negative impact on prognosis calls for further investigation of
the barriers to screening and diagnosis of depression in multimorbid
patients.