Management of depression in elderly general practice patients

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Abstract
Objective — To describe general practitioners' (GP) management (i.e., recognition and treatment) of depression in elderly patients. Design -Two separate studies were performed: (a) to study recognition of depression, a postal survey was sent to GPs; (b) to evaluate the consistency of treatment, patients considered depressed by GPs were described. Setting — general practices in the West of The Netherlands. Subjects — 65 GPs, and 44 patients of 7 GPs. Main outcome measures — (a) degree of recognition of depression as described in major depression case-vignettes (b) consistency of treatment. Results — (a) On average 65% of the GPs recognized every depressive symptom in case-vignette one, while 52% of GPs recognized each symptom in case two. Most (39) doctors used a time criterion of less than 5 weeks for depressive disorder. (b) Depressed patients with at least three depressive symptoms all received treatment. Chronically depressed patients appeared to be treated somewhat inadequately. Conclusion — The results suggest some inadequate knowledge of criteria for major depression and some inconsistency in treatment. The management of depression in elderly GP patients appears to need improvement.