Management of depression in elderly general practice patients

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