The prognosis of undetected depression in older general practice patients. A one year follow-up study
Abstract
Background Late-life depression often remains undetected in primary care. However, as there is evidence that GPs do identify those with the most severe and persistent disorders, it is important to know more about the prognosis of depressive disorders that are not detected by GPs.Methods A one-year follow-up study of depressed patients of 55 years and older consulting their GP in The Netherlands. A two-stepped screening procedure was used to diagnose depression using the GDS-15 and PRIME-MD. GPs and patients were not informed about the results. The course of depression was measured with the MADRS and PRIME-MD, at six and twelve months. Remission was defined by no longer fulfilling DSM-criteria for depressive disorder and a MADRS-score below 10. The prognosis of those not detected by GPs was compared to those that were detected.Results 73 patients were followed for one year. Among the 49 (67%) patients that were not detected by their GP as being depressed, 33% had remitted after one year. Of the 24 (33%) depressed patients that were detected by their GP, 37% had remitted after one year. Detected patients tended to have more serious depression and more comorbid anxiety than undetected patients.Conclusions Although GPs identify older depressed patients who are most in need of treatment, the prognosis of patients that go undetected is poor.
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For older people with undetected depression, longer-term prognosis is poorer than for those with depression whose General Practitioner is aware.
“For older people with undetected depression, longer-term prognosis is poorer than for those with depression whose General Practitioner (GP) is aware [20].”
From Can support workers from AgeUK deliver an intervention to support older people with anxiety and depression? A qualitative evaluation (2019) · cites this paper as [20]
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- Authors
- Licht-Strunk, E., Beekman, A. T. F., de Haan, M., & van Marwijk, H. W. J.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Licht-Strunk, Els
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 114
- Issue
- 1-3
- Pages
- 310-315
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1995490323
- Cited by
- 60
- References
- 25
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 1 · 2021: 2 · 2020: 1 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 4 · 2015: 4 · 2014: 4 · 2013: 7 · 2012: 3
- FWCI
- 7.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- geriatric depression, depression prognosis, general practice, primary care, depression remission, depression screening, GDS-15, PRIME-MD, anxiety comorbidity, older adults
- MeSH terms
- Aged, Aged, 80 and over, Anxiety, Depression, Major Depressive Disorder, Diagnosis, Differential, Family Practice, Female, Follow-Up Studies, Humans, Male, Middle Aged, Netherlands, Primary Health Care, Prognosis, Psychiatric Status Rating Scales, Severity of Illness Index, Geriatric Assessment, Comorbidity, Prevalence
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