The prevalence and recognition of depression in elderly patients attending their general practitioners

MacDonald, Alastair John Douglas (1985) The prevalence and recognition of depression in elderly patients attending their general practitioners. MD thesis, University of Glasgow.

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This thesis reports an attempt to establish the prevalence of depressive states in elderly attenders at certain general practice surgeries, to examine the accuracy with which depression is recognised by general practitioners, and to throw light on the course of such states in this 'community' sample. A discrepancy between age-related prevalence rates of non-psychotic disorders in patients admitted to hospital in the United Kingdom and those not admitted is reported from published data. Using depressive states as an example of this type of disorder, suggested reasons for this discrepancy are examined in the light of a review of the relevant literature- including the possibilities that prevalence declines with age, that older people are less likely to be in contact with general practitioners, that these disorders are less likely to be recognised by general practitioners in older patients, and that older patients with depressive states are less likely to be referred for specialist help and therefore admitted. After consideration of various problems of method, a study of the prevalence of depressive states in 235 attenders over the age of 65 at the surgeries of 12 general practitioners is described. The prevalence of 'significantly depressed states' in this group was determined as 30.6%, and 82.5% of those with such states were recognised as depressed by their general practitioners, although only 1 was referred to psychiatric care. These states were found to be highly correlated with consumption of psychotropic medication and rates of consultation with general practitioners, and one third of them persisted over a 9-month follow-up period, indicating their importance. These results are discussed in the light of other work of a similar nature in younger age-groups, and it is concluded that the cost-effectiveness of efforts to improve general practitioners' rates of recognition of depressive states is likely to be limited, whereas efforts to improve selection for specialist referral would be more profitable, especially if improvement in outcome could be shown as a result of such intervention.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Medicine, Clinical psychology, Gerontology
Date of Award: 1985
Depositing User: Enlighten Team
Unique ID: glathesis:1985-76581
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 19 Nov 2019 14:06
Last Modified: 19 Nov 2019 14:06

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