Recognition of depressive symptoms in the elderly: what can help the patient and the doctor.

The general public heavily underrecognizes depression and depressive symptoms. This underrecognition is more pronounced among elderly people, and this study is an initial attempt to quantify the problem in a Greek elderly sample. Additionally the authors attempt to identify patient-related factors, which can assist a subject to recognize the depressive symptoms and the general practitioner to note their existence. Members of senior citizen centers (n = 682) participated in presentations about "depression in the elderly" and completed a questionnaire including the GDS-4 scale, four questions concerning depression risk factors and a question concerning a recent visit to a physician for depressive symptoms. Amongst those participating, 35.8% presented depressive symptoms (GDS-4 > or = 2). The calculated rate for recognition of depression in the studied population was very low (17.3%). Patients with depressive symptoms were more often females and had a higher proportion of past history of depression and a lack of social support. Patients with a past history of depression and more severe forms of illness consulted a doctor more frequently. Finally, subjects suffering from depressive symptoms and comorbid medical illness were characterized by a higher proportion of past history, lack of support, and existence of multiple risk factors. The authors propose that the inclusion in public campaigns of activities with an experiential dimension, e.g., patient videos and the use of a very simple screening tool, such as the GDS-4 scale by general practitioners (GP), could be helpful in improving the recognition of depressive symptoms by the patient and his/her relatives and its diagnosis by the doctor. This proposition awaits formal proof in future studies. Copyright 2002 Wiley-Liss, Inc.