A comparison of GP and GDS diagnosis of depression in late life among multimorbid patients - results of the MultiCare study
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A comparison of GP and GDS diagnosis of depression in late life among multimorbid patients - results of the MultiCare study. / Schwarzbach, Michaela; Luppa, Melanie; Hansen, Heike; König, Hans-Helmut; Gensichen, Jochen; Petersen, Juliana J; Schön, Gerhard; Wiese, Birgitt; Weyerer, Siegfried; Bickel, Horst; Fuchs, Angela; Maier, Wolfgang; van den Bussche, Hendrik; Scherer, Martin; Riedel-Heller, Steffi G; MultiCare Study Group.
In: J AFFECT DISORDERS, Vol. 168, 15.10.2014, p. 276-83.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - A comparison of GP and GDS diagnosis of depression in late life among multimorbid patients - results of the MultiCare study
AU - Schwarzbach, Michaela
AU - Luppa, Melanie
AU - Hansen, Heike
AU - König, Hans-Helmut
AU - Gensichen, Jochen
AU - Petersen, Juliana J
AU - Schön, Gerhard
AU - Wiese, Birgitt
AU - Weyerer, Siegfried
AU - Bickel, Horst
AU - Fuchs, Angela
AU - Maier, Wolfgang
AU - van den Bussche, Hendrik
AU - Scherer, Martin
AU - Riedel-Heller, Steffi G
AU - MultiCare Study Group
N1 - Copyright © 2014 Elsevier B.V. All rights reserved.
PY - 2014/10/15
Y1 - 2014/10/15
N2 - BACKGROUND: The objective of the study was to compare General Practitioners׳ (GPs) diagnosis of depression and depression diagnosis according to Geriatric Depression Scale (GDS) and to identify potential factors associated with both depression diagnosis methods.METHODS: The data were derived from the baseline wave of the German MultiCare1 study, which is a multicentre, prospective, observational cohort study of 3177 multimorbid patients aged 65+ randomly selected from 158 GP practices. Data were collected in GP interviews and comprehensive patient interviews. Depressive symptoms were assessed with a short version of the Geriatric Depression Scale (15 items, cut-off 6). Cohen׳s kappa was used to assess agreement of GP and GDS diagnoses. To identify factors that might have influenced GP and GDS diagnoses of depression, binary logistic regression analyses were performed.RESULTS: Depressive symptoms according to GDS were diagnosed in 12.6% of the multimorbid subjects, while 17.8% of the patients received a depression diagnosis by their GP. The agreement between general practitioners and GDS diagnosis was poor. To summarize we find that GPs and the GDS have different perspectives on depression. To GPs somatic and psychological comorbid conditions carry weight when diagnosing depression, while cognitive impairment in form of low verbal fluency, pain and comorbid somatic conditions are relevant for a depression diagnosis by GDS.CONCLUSIONS: Each depression diagnosing method is influenced by different variables and therefore, has advantages and limitations. Possibly, the application of both, GP and GDS diagnoses of depression, could provide valuable support in combining the different perspectives of depression and contribute to a comprehensive view on multimorbid elderly in primary care setting.
AB - BACKGROUND: The objective of the study was to compare General Practitioners׳ (GPs) diagnosis of depression and depression diagnosis according to Geriatric Depression Scale (GDS) and to identify potential factors associated with both depression diagnosis methods.METHODS: The data were derived from the baseline wave of the German MultiCare1 study, which is a multicentre, prospective, observational cohort study of 3177 multimorbid patients aged 65+ randomly selected from 158 GP practices. Data were collected in GP interviews and comprehensive patient interviews. Depressive symptoms were assessed with a short version of the Geriatric Depression Scale (15 items, cut-off 6). Cohen׳s kappa was used to assess agreement of GP and GDS diagnoses. To identify factors that might have influenced GP and GDS diagnoses of depression, binary logistic regression analyses were performed.RESULTS: Depressive symptoms according to GDS were diagnosed in 12.6% of the multimorbid subjects, while 17.8% of the patients received a depression diagnosis by their GP. The agreement between general practitioners and GDS diagnosis was poor. To summarize we find that GPs and the GDS have different perspectives on depression. To GPs somatic and psychological comorbid conditions carry weight when diagnosing depression, while cognitive impairment in form of low verbal fluency, pain and comorbid somatic conditions are relevant for a depression diagnosis by GDS.CONCLUSIONS: Each depression diagnosing method is influenced by different variables and therefore, has advantages and limitations. Possibly, the application of both, GP and GDS diagnoses of depression, could provide valuable support in combining the different perspectives of depression and contribute to a comprehensive view on multimorbid elderly in primary care setting.
U2 - 10.1016/j.jad.2014.06.020
DO - 10.1016/j.jad.2014.06.020
M3 - SCORING: Journal article
C2 - 25080391
VL - 168
SP - 276
EP - 283
JO - J AFFECT DISORDERS
JF - J AFFECT DISORDERS
SN - 0165-0327
ER -