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Research

Unrecognised depression among older people: a cross-sectional study from Norwegian general practice

Lars Christian Kvalbein-Olsen, Eivind Aakhus, Ole R Haavet and Erik L Werner
BJGP Open 2023; 7 (1): BJGPO.2022.0135. DOI: https://doi.org/10.3399/BJGPO.2022.0135
Lars Christian Kvalbein-Olsen
1 Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
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  • ORCID record for Lars Christian Kvalbein-Olsen
  • For correspondence: l.c.kvalbein-olsen@medisin.uio.no
Eivind Aakhus
2 Department of Old Age Psychiatry, Innlandet Hospital Trust, Brumunddal, Norway
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Ole R Haavet
1 Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
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Erik L Werner
1 Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
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Article Figures & Data

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  • Figure 1.
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    Figure 1. Flow chart of recruitment process and data collection. PHQ-9 = Patient Health Questionnaire-9.

    *Three GPs misunderstood the recruitment procedure, selectively recruiting only patients with depression (instead of every patient aged ≥65 years).

  • Figure 2.
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    Figure 2. GP’s knowledge of a current depression, related to Patient Health Questionnaire-9 score.
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    Figure 3. Percentage frequency of consultations, grouped by Patient Health Questionnaire-9 level

Tables

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    Table 1. Patient characteristics, and prevalence of moderate-to-severe depressive symptoms
    GroupPart of total (N’)Prevalence of PHQ-9≥10 in groupNumbers answered on item
    Patient answers N % (N/N’) n % (n/N )
    Total patient samples: 5276011.4%
    Part 1 total:3834411.5%
    Part 1 complete sets3694311.7%
    Part 1 GP parts missing141N/A
    Part 2 :1441611.1%
    Sex
    Female29856.5%4214.1% (of 298)527
    Male22943.5%187.9% (of 229)527
    Age, years
    65–6914026.6%1812.9% (of 140)527
    70–7414427.3%139.0% (of 144)527
    75–7912523.7%1411.2% (of 125)527
    80–847514.2%912.0% (of 75)527
    ≥85438.2%614.0% (of 43)527
    Marital status
    Married or cohabitant33763.9%3610.7% (of 337)520
    Widowed10620.1%1716.0% (of 106)520
    Divorced499.3%48.9% (of 49)520
    None336.3%39.1% (of 33)520
    Various
    Live near (grand)children40178.0%5413.5% (of 401)514
    Foreign native language214.1%628.6% (of 21)515
    Smokes5310.3%1630.2% (of 53)513
    Hypnotics13225.6%2518.9% (of 132)516
    Anxiolytics5410.5%1935.2% (of 54)516
    Home-based nursing service336.4%1236.4% (of 33)516
    Patient reported symptoms
    SHC ≥20 (9 = median)8916.9%5923.2% (of 254)526
    Probable general anxiety disorder:
    GAD-7≥10407.6%2972.5% (of 40)527
    N/A
    GPs answers (total n = 369):
    GP stated consultation topics N % (N/N’) n % (n/N) (N’)
    Routine control13436.6%86.0% (of 134)369
    Somatic problem21458.0%2411.2% (of 214)369
    Pain problem6116.5%1016.4% (of 61)369
    Mental health problem34 9.2% 1544.1% (of 34)369
    Social or relational problem184.9%738.9% (of 18)369
    Sleep problem184.9%527.8% (of 18)369
    Consultation frequency
    Frequent patient (≥ x5/year)16346.4%2817.2% (of 163)351
    Occasionally (2–4 x/year)14039.9%75.0% (of 140)351
    Seldom (0–1 x/year)4813.7%48.3% (of 48)351
    • GAD-7 = General Anxiety Disorder 7-item scale. PHQ-9 = Patient Health Questionnaire-9. SHC = subjective health complaints.

    • Missing data: 7 patients did not answer demographic questions, but did complete the PHQ-9 and had completed GP forms. These were, therefore, included in analysis.

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    Table 2. Sample variation between the two different recruitment methods
    Sample 1+2:Sample 1:Sample 2:
    n%n%n%
    Total responders without GP part 527383144
    Sex
    Female29856.5%23060.1%6847.2%
    Male22943.5%15339.9%7652.8%
    Age, years
    65–6914026.6%10326.9%3725.7%
    70–7414427.3%10727.9%3725.7%
    75–7912523.7%8321.7%4229.2%
    80–847514.2%5915.4%1611.1%
    ≥85438.2%318.1%128.3%
    Depressive (PHQ-9) level
    None (<5)34164.7%24864.8%9364.6%
    Mild (5–9)12623.9%9123.8%3524.3%
    Moderate (10–19)5310.1%3910.2%149.7%
    Severe (20–29)71.3%51.3%21.4%
    Mean values Mean ± SD Mean ± SD Mean ± SD
    Mean age74.50±6.6 years74.54±6.6 years74.48±6.7 years
    Mean SHC score11.15±8.9511.26±9.0710.92±8.65
    Mean PHQ-9 score4.36±4.444.30±4.394.55±4.59
    Mean GAD-7 score2.87±3.642.71±3.373.28±4.27
    • GAD-7 = General Anxiety Disorder 7-item scale. PHQ-9 = Patient Health Questionnaire-9. SHC = subjective health complaints.

Supplementary Data

  • KO_BJGPO.2022.0135_Supp.pdf -

    Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.

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Unrecognised depression among older people: a cross-sectional study from Norwegian general practice
Lars Christian Kvalbein-Olsen, Eivind Aakhus, Ole R Haavet, Erik L Werner
BJGP Open 2023; 7 (1): BJGPO.2022.0135. DOI: 10.3399/BJGPO.2022.0135

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Unrecognised depression among older people: a cross-sectional study from Norwegian general practice
Lars Christian Kvalbein-Olsen, Eivind Aakhus, Ole R Haavet, Erik L Werner
BJGP Open 2023; 7 (1): BJGPO.2022.0135. DOI: 10.3399/BJGPO.2022.0135
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Keywords

  • depression
  • care of older people
  • aged
  • epidemiology
  • general practice
  • primary healthcare

More in this TOC Section

  • Evaluating the UK’s first national prescribing assessment for GPs in training using an online survey
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  • Patients’ views and experiences of delayed diagnosis of inflammatory bowel disease: a qualitative study
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