DEPRESSION IN GERIATRIC PATIENTS. Bojana Potic, Goran Gajic, Dragoslav P. Milosevic University of Belgrade, Serbia

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1 DEPRESSION IN GERIATRIC PATIENTS Bojana Potic, Goran Gajic, Dragoslav P. Milosevic University of Belgrade, Serbia

2 Introduction: Older people may suffer a wide range od psychiatric difficulties;those with concurrent physical illnesses are particularly vulnerable. Although these conditions tend to be underdetected, their outcome with appropriate management is often excellent.

3 Methods: We analysed 100 patients with different psysical chronic illness. There were 60% female and 40% male, aged from 65 to 90, middle age 72. Most of them suffered from different cardiovascular diseases (80%) such as cardiomyopathies, ishaemic heart disease and high blood preasure. Other frequent diseases were diabetes mellitus (45%), respiratory diseases (30%) and malignancy (21%). Different diagnostic physical examinations, Hamilton Rating Scale for depression, Geriatric Depression Scale (GDS) and Mini Mental State Examination (MMSE) test were used.

4 Geriatric Depression Scale (GDS) Sample rating sheet from the GDS Instructions: Choose the best answer for how you have felt, over the past week. 1. Are you basically satisfied with your life? No 2. Have you dropped many of your activities and interests? Yes 3. Do you feel your life is empty? Yes 4. Do you often get bored? Yes 5. Are you hopeful about the future? No 6. Are you bothered by thoughts you can't get out of your head? Yes 7. Are you in good spirits most of the time? No 8. Are you afraid something bad is going to happen to you? Yes 9. Do you feel happy most of the time? No 10. Do you often feel helpless? Yes 11. Do you often get restless of fidgety? Yes 12. Do you prefer to stay at home, rather than going out and doing new things? Yes 13. Do you frequently worry about the future? Yes 14. Do you feel you have more problems with your memory than most? Yes 15. Do you thing it is wonderful to be alive now? No 16. Do you often feel down-hearted and blue (sad)? Yes 17. Do you feel pretty worthless the way you are? Yes 18. Do you worry a lot about the past? Yes 19. Do you find life very exciting? No. 20. Is it hard for you to start on new projects (plans)? Yes 21. Do you feel full of energy? No 22. Do you feel that your situation is hopeless? Yes 23. Do you think most people are better off (in their lives) than you are? Yes 24. Do you frequently get upset over little things? Yes 25. Do you frequently feel like cryig? Yes 26. Do you have trouble concentrating? Yes 27. Do you enjoy getting up in the morning? No 28. Do you prefer to avoid social gatherings (get-togethers)? Qes 29. Is it easy for you to make decisions? No 30. Is your mind as clear as it used to be? No Note: (1) Answers refer to responses which score '1': (2) bracketed phrases refer to alternative ways of expressing the questions, (3) questions in bold comprise the 15-item version. Suggested meaning of scores (GDS30) 0-4 normal, depending on age, education, cpmplaints, 5-8 mild, 8-11 moderate, severe, and thresholds for possible 'case' of depression 5 for GDS15 and 2 for GDS4

5 Results: Applied scales showed that depression was present in the group of patients with intensive pain and dispnoea. Depression was presented in 25% of patients. Depression was more common in women. Depressed mood, guilt, anxiety and diurnal mood variation were more common in women than in man with depression. In this group there was mild form of depression in 20% and moderate form in 5% of patients.

6 Discussion: Depression often presents in a less typical fashion on old age with core complaint of low mood being less prominent or even absent. This clearly implicates for under- or misdiagnosis of depression in elderly. Depression is more common in physically ill than in healthy older people (p<0,001: Spearman s test correlation, Chi-Square test, Fisher exact test).

7 References: 1. Blazer DG(2003). Depression in late life:review and commentary. Journal of Gerontology: Medical Sciences, 58a, Katona CLE and Shankar KK(2004). Depression in old age. Reviews in Clinical Gerontology, 14, Taylor D, Paton C and Kerwin R(2007). The Maudsley prescrising guidelines, 9 th edn. Informa Health care, London.