Psychiatric screening in geriatric primary care : should it be for depression alone ?
In this study, we examined whether the association between depressive and nondepressive forms of psychopathology was similar in geriatric and nongeriatric medical patients.
We also examined the relationship between each type of pathology and health care utilization and global ratings of physical and mental health.
In a VA hospital general medical outpatient clinic, 508 patients completed the SCREENER, which is a brief self-report questionnaire that screens for a range of psychiatric disorders, along with a self-report questionnaire regarding subjective health and medical care utilization.
Of these patients, 98% were male, and the median age was 63 years.
Patients aged 63 and over were compared to younger patients.
In both geriatric and younger adult patients, we found substantial comorbidity between depressive and nondepressive forms of pathology.
Moreover, in both age groups, there were significant associations between both depressive and nondepressive symptoms and fair-to-poor self-rated physical and mental health and increased medical care utilization.
Approximately half of the cases of nondepressive disorders in the elderly were not comorbid with depression, and thus would not have been detected by screening for depression alone.
Therefore, psychiatric case finding in primary care of geriatric males should be directed at anxiety, substance, and somatoform disorders, as well as at depression, for treatment resources to be triaged to maximally decrease morbidity and cost.
Mots-clés Pascal : Etat dépressif, Trouble humeur, Diagnostic, Soin santé primaire, Association morbide, Trouble psychiatrique, Prévalence, Epidémiologie, Vieillard, Homme
Mots-clés Pascal anglais : Depression, Mood disorder, Diagnosis, Primary health care, Concomitant disease, Mental disorder, Prevalence, Epidemiology, Elderly, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0452530
Code Inist : 002B18E. Création : 01/03/1996.