Unrecognized depression among the elderly: a cross-sectional study from norwegian general practice

Background Depression is common in old age and is associated with both disability, increased mortality and increased impairment from physical diseases.

Aim To estimate the prevalence of depression among old patients in Norwegian general practice, to evaluate the extent they talk about it during their consultation, if it was previously known or suspected by their general practitioner (GP), and how frequent the depressed patients visit their GP.

Design & setting Cross-sectional study among patients and GPs at 18 primary care clinics in the south of Norway.

Method Patients ≥65 years who visited their GP were asked to complete the Patient Health Questionaire-9 (PHQ9). The GPs reported what kind of issues the patient presented at the consultation, if a current depression were known, and the consultation frequency.

Results 44 (11%) of 383 patients reported moderate or severe depressive symptoms (PHQ9 ≥10). Among the cases with data from both patient and GP (369), 38 patients (10%) reported moderately depressive symptoms. Of these only 12 (32%) mentioned psychological problems to their GP during their consultation, 12 (32%) were neither known to the GP with previous depression nor suspected by the GP of having a current one, and 68% of them visit their GP ≥5 times a year.

Conclusion Elderly patients tend to speak little of their depression to the GP. Almost 1 of 3 elderly patients with moderate depressive symptoms were unrecognised by their GP. GPs should more often suspect potential mental health problems in old patients who come frequently to visits.