A Cross-Sectional Analysis of Factors that Influence the Detection of Depression in Older Primary Care Patients

2005 ◽  
Vol 39 (4) ◽  
pp. 262-265 ◽  
Author(s):  
Jon J Pfaff ◽  
Jon J Pfaff ◽  
Osvaldo P Almeida
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Older Patients ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Self Report ◽  
Screening Tools ◽  
Cross Sectional ◽  
Summary Sheet

Objective: To determine the characteristics of depressed older patients whose mental health status is detected by their general practitioner (GP). Method: Cross-sectional analytical design of 218 patients scoring above the cut-off (≥ 16) of the Center for Epidemiological Studies – Depression Scale (CES-D), from a sample of 916 consecutive patients aged 60 years or over attending one of 54 randomly selected GPs in Western Australia. Prior to their medical consultation, patients completed a self-report questionnaire, which included questions about depressive symptomatology (CES-D). Following the consultation, general practitioners recorded the patient's presenting complaint(s), medication information, and mental health details on a patient summary sheet. Results: Among these 218 patients, 39.9% (87/218) were correctly classified as depressed by their GP. Detection of depressive symptomatology was associated with patients who acknowledged taking sleeping tablets (OR = 2.6, 95% CI = 1.3–5.4), had CES-D scores indicative of major depression (≥ 22) (OR = 2.8, 95% CI = 1.4–5.6) and were thought to be at risk for suicide (OR = 35.1, 95% CI = 4.5–274.2). Conclusions: While GPs are most apt to detect depression among older patients with prominent mental health symptoms, many patients in this age group silently experience significant depressive symptomatology and miss the opportunity for effective treatment. The routine use of screening tools in primary care is recommended to enhance the detection rate of depression in older adults.

Patients who somatize in primary care: a longitudinal study of cognitive and social characteristics

1996 ◽  
Vol 26 (5) ◽  
pp. 937-951 ◽  
Author(s):  
Laurence J. Kirmayer ◽  
James M. Robbins
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Depressive Symptomatology ◽  
Emotional Problem ◽  
Somatic Symptoms ◽  
Self Report ◽  
Care Utilization ◽  
Sociodemographic Characteristics

SynopsisWe examined the cognitive and sociodemographic characteristics of patients making somatic presentations of depression and anxiety in primary care. Only 15% of patients with depressive symptomatology on self-report, and only 21 % of patients with current major depression or anxiety disorders on diagnostic interview, presented psychosocial symptoms to their GP. The remainder of patients with psychiatric distress presented exclusively somatic symptoms and were divided into three groups - initial, facultative and true somatizers - based on their willingness to offer or endorse a psychosocial cause for their symptoms. Somatizers did not differ markedly from psychologizers in sociodemographic characteristics except for a greater proportion of men among the true somatizers. Compared to psychologizers, somatizers reported lower levels of psychological distress, less introspectiveness and less worry about having an emotional problem. Somatizers were also less likely to attribute common somatic symptoms to psychological causes and more likely to endorse normalizing causes. In the 12 months following their initial visit, somatizers made less use of speciality mental health care and were less likely to present emotional problems to their GP. Somatizers were markedly less likely to talk about personal problems to their GP and reported themselves less likely to seek help for anxiety or sadness. Somatization represents a persistent pattern of illness behaviour in which mental health care is not sought despite easily elicited evidence of emotional distress. Somatization is not, however, associated with higher levels of medical health care utilization than that found among patients with frank depression or anxiety.

A Cross-National Self-Report Measure of Depressive Symptomatology

1993 ◽  
Vol 5 (2) ◽  
pp. 147-156 ◽  
Author(s):  
Margaret Gatz ◽  
Boo Johansson ◽  
Nancy Pedersen ◽  
Stig Berg ◽  
Chandra Reynolds
Keyword(s):  
Depressive Symptomatology ◽  
Depression Scale ◽  
Well Being ◽  
Epidemiological Studies ◽  
Psychomotor Retardation ◽  
Self Report ◽  
Symptoms Of Depression ◽  
Representative Samples ◽  
Report Measure ◽  
Cross National

The Center for Epidemiological Studies Depression scale (CES-D) was administered in Swedish to two representative samples, one aged 84 to 90 (mean = 87), the second aged 29 to 95 (mean = 61). There were both linear and quadratic differences with age: the oldest individuals were highest on depressive symptoms, but younger adults were higher than middle-aged. Dimensions or subscales identified by previous studies were generally replicated, including a sadness and depressed mood factor, a psychomotor retardation and loss of energy factor, and a well-being factor (on which items are reverse-scored to indicate depression). The findings support cross-national use of the CES-D to assess self-reported symptoms of depression in adults and older adults.

scholarly journals Abusive experiences and psychiatric morbidity in women primary care attenders

2003 ◽  
Vol 183 (4) ◽  
pp. 332-339 ◽  
Author(s):  
Jeremy Coid ◽  
Ann Petruckevitch ◽  
Wai-Shan Chung ◽  
Jo Richardson ◽  
Stirling Moorey ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Substance Misuse ◽  
Psychiatric Morbidity ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Health Measures ◽  
Post Traumatic ◽  
Mental Health Effects

BackgroundAbusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging.AimsTo measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders.MethodA cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression.ResultsChildhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year.ConclusionsAbuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.

scholarly journals AGEISM IN HEALTH CARE: 72 IS NOT A DIAGNOSIS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S79-S79
Author(s):  
Phyllis A Greenberg ◽  
Tarynn Johnson
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Older Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Accepted Part ◽  
Perceptions Of Aging ◽  
Primary Care Clinicians ◽  
Mental Slowness

Abstract This poster examines what value, if any, there is in using age as a predictor or impetus for testing, examining and diagnosing older adults. In a cross sectional survey (Davis et al. (2011) used the Expectations Regarding Aging Scale to assess primary care clinicians perceptions of aging in the domains of physical/mental health and cognitive functioning. Sixty-four percent of respondents agreed with the statement “Having more aches and pains is an accepted part of aging while 61% agreed that the “Human body is like a car when it gets old it gets worn out. And 51% agreed that one should expect to become more forgetful with age while 17% agreed that mental slowness is impossible to escape. How might these attitudes and biases effect how older adults are diagnosed, heard, spoken to, and treated (medical treatment as well as patient/professional interaction)? Are older patients/clients underserved or over served? Is forgetting where you put your keys always or even usually a sign of dementia? How helpful then is the use of age and are there other factors that should and can take precedence? What do we know and what don’t we know if we know someone’s age? Successful and innovative tools are explored that acknowledge age biases and strategies are presented to change age biases in education, training and practice.

Dimensions of the Center of Epidemiological Studies–Depression Scale for People with Arthritis from the UK

1998 ◽  
Vol 83 (3) ◽  
pp. 915-919 ◽  
Author(s):  
Julie H. Barlow ◽  
Chris C. Wright
Keyword(s):  
Depressive Symptomatology ◽  
Item Analysis ◽  
Depression Scale ◽  
Population Data ◽  
Epidemiological Studies ◽  
Self Report ◽  
Dimensional Structure ◽  
National Study ◽  
Self Worth ◽  
The Uk

The aim of this study was to investigate the factor structure and to conduct an item analysis of the Center for Epidemiological Studies–Depression Scale (CES–D) among people with arthritis from the UK. This 20-item self-report scale was designed by Radloff in 1977 to measure depressive symptomatology in the general population. Data were drawn from a national study and collected through self-administered questionnaires mailed to participants, each of whom had a confirmed diagnosis of arthritis. Reliability and structure of the scale were examined using standard item analysis, internal consistency (Cronbach alpha), and principal components analysis. A four-dimensional structure was identified: Self-worth, Depressed Affect, Positive Affect, and Somatic Disturbance; three items loaded on two factors and were excluded from consideration. Comparisons with previous studies indicated some differences in the subscales and showed that, in this sample, two subscales might be artifacts of measurement. In samples of people with arthritis from the UK, use of the total score may not reflect accurate depressive symptomatology and the subscale scores should be used with caution.

Psychometric Evaluation of the German Version of the Centre for Epidemiological Studies Depression Scale for Children (CES-DC)

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C. Barkmann ◽  
M. Erhart ◽  
M. Schulte-Markwort ◽  
N. Wille ◽  
U. Ravens-Sieberer
Keyword(s):  
Children And Adolescents ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Population Based ◽  
Self Report ◽  
Factorial Validity ◽  
German Version ◽  
Rater Agreement ◽  
Cross Sectional ◽  
Parental Assessment

Objectives:To examine the psychometric properties and test-theoretical quality of the German version of the Centre for Epidemiological Studies Depression Scale for Children (CES-DC), a 20 items comprising screening instrument which measures the frequency of parent- and self-reported depressive symptoms in children and adolescents.Methods:Using a population-based, representative sample of N=2.863 7 to 17 year old German children and adolescents, factorial validity by means of linear structural modelling, cross-sectional coefficients of reliability, inter-rater agreement and normative scores are determined.Results:In a population-based German sample, the 4-factor version of the CES-DC following Radloff (1977) is considered to have good factorial validity and stability across age and informant version. The main problems of the questionnaire are the high difficulties of the items, strong floor effects of the scales and low cross-sectional reliability, which is just acceptable for screening purposes. The low inter-rater agreement indicate that parental assessment can replace self-assessment only to a limited degree.Conclusion:The strengths and weaknesses of the CES-DC are discussed taking into consideration previous data and comparable tests. Particular advantages are the existence of the parent report form and the adult version, as well as its multifactorial structure. Parental assessment should be supplemented by self-report data whenever possible.

Comorbidities and depression in older adults with HIV

Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 551 ◽  
Author(s):  
Richard J. Havlik ◽  
Mark Brennan ◽  
Stephen E. Karpiak
Keyword(s):  
Older Adults ◽  
New York ◽  
Longitudinal Research ◽  
Depressive Symptomatology ◽  
Clinical Care ◽  
Depression Scale ◽  
Female Gender ◽  
Epidemiological Studies ◽  
Sensory Loss ◽  
Cross Sectional

Objective To investigate whether the high rates of depression found in older adults living with HIV are associated with the number and types of comorbidities. Methods: The Research on Older Adults with HIV (ROAH) study collected self-reported health data on ~1000 New York City HIV-positive men and women aged 50 years and older. Participants provided data on health problems experienced in the past year and depressive symptomatology (Center for Epidemiological Studies Depression Scale (CES-D)). Data were analysed using a non-parametric test of association and multiple regression analysis. Results: The correlation between CES-D scores and number of comorbidities was significant (r = 0.24). In multivariate analyses, depression remained a significant covariate of the number of comorbid conditions, in addition to female gender, inadequate income, history of drug and alcohol use, AIDS diagnosis and self-rated health. Correlations of depression with specific comorbidities varied. Significant correlations with sensory loss and dermatological problems were observed. Significant correlations existed with heart and respiratory conditions as well as fractures, but the directionality of these cross-sectional relationships is uncertain. Conclusions: The findings suggest the need for further longitudinal research to understand how high rates of depressive symptoms are related to comorbidities. Focussed clinical care that strives to prevent the collapse of the immune system must evolve into an effective treatment strategy for multimorbidities, where HIV is but one of many other chronic illnesses. If the management of depression continues to be a low priority, the older person with HIV may experience an avoidable reduction in life expectancy.

scholarly journals What is the prevalence, and what are the clinical correlates, of insulin resistance in young people presenting for mental health care? A cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025674 ◽  
Author(s):  
Elizabeth M Scott ◽  
Joanne S Carpenter ◽  
Frank Iorfino ◽  
Shane P M Cross ◽  
Daniel F Hermens ◽  
...  
Keyword(s):  
Mental Health ◽  
Insulin Resistance ◽  
Primary Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Self Report ◽  
Model Assessment ◽  
Cross Sectional ◽  
Younger Age

ObjectivesTo report the distribution and predictors of insulin resistance (IR) in young people presenting to primary care-based mental health services.DesignCross-sectional.SettingHeadspace-linked clinics operated by the Brain and Mind Centre of the University of Sydney.Participants768 young people (66% female, mean age 19.7±3.5, range 12–30 years).Main outcome measuresIR was estimated using the updated homeostatic model assessment (HOMA2-IR). Height and weight were collected from direct measurement or self-report for body mass index (BMI).ResultsFor BMI, 20.6% of the cohort were overweight and 10.2% were obese. However, <1% had an abnormally high fasting blood glucose (>6.9 mmol/L). By contrast, 9.9% had a HOMA2-IR score >2.0 (suggesting development of IR) and 11.7% (n=90) had a score between 1.5 and 2. Further, there was a positive correlation between BMI and HOMA2-IR (r=0.44, p<0.001). Participants in the upper third of HOMA2-IR scores are characterised by younger age, higher BMIs and depression as a primary diagnosis. HOMA2-IR was predicted by younger age (β=0.19, p<0.001) and higher BMI (β=0.49, p<0.001), together explaining 22% of the variance (F(2,361)=52.1, p<0.001).ConclusionsEmerging IR is evident in a significant subgroup of young people presenting to primary care-based mental health services. While the major modifiable risk factor is BMI, a large proportion of the variance is not accounted for by other demographic, clinical or treatment factors. Given the early emergence of IR, secondary prevention interventions may need to commence prior to the development of full-threshold or major mood or psychotic disorders.

scholarly journals Time spent in retirement, health and well-being

2017 ◽  
Vol 41 (S1) ◽  
pp. S339-S340 ◽  
Author(s):  
A.R. Lucas ◽  
F. Daniel ◽  
S. Guadalupe ◽  
I. Massano-Cardoso ◽  
H. Vicente
Keyword(s):  
Mental Health ◽  
Satisfaction With Life ◽  
Depressive Symptomatology ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Well Being ◽  
Cross Sectional Study ◽  
Satisfaction With Life Scale ◽  
Cross Sectional ◽  
Health And Well Being

IntroductionFrom a life-span developmental perspective, retirement can be considered a life event that entails a complex psychological challenge, including leaving one's professional life and organizing/enjoying the newly available free time. The literature about retirement identifies different stages and patterns of transition/adaption associated with time spent in retirement.ObjectivesTo analyze the association between time spent in retirement and subjective measures of mental health, depressive symptomatology, loneliness and satisfaction with life.MethodsQuantitative cross-sectional study with 641 participants (M = 74,86). The instruments included: sociodemographic questionnaire; mental health inventory (MHI-5); geriatric depression scale (GDS); UCLA loneliness scale; satisfaction with life scale (SWLS).ResultsStatistically significant differences in all the health and well-being variables addressed were found between subgroups of time spent in retirement (MHI-5: P = 0.001; GDS: P < 0.001; UCLA: P = 0.038; SWLS: P = 0.022). Mental health and satisfaction with life increases in the first year after retirement, but during the second year, they decrease to the levels found in pre-retirement. Loneliness and depressive symptomatology follow an inverted pattern. With the passing of years, loneliness and depression tend to increase; mental health and satisfaction with life tend to decrease.ConclusionsThe results provide support to the hypotheses of honeymoon and disenchantment phases in the recently retired and to the existence of different patterns of transition/adaptation associated with time spent in retirement. They also highlight the relevance of devising intervention strategies that enable individuals to maintain the satisfaction levels with life and mental health achieved during the first phase of retirement.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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