Michaela Schwarzbach1, Melanie Luppa2, Heike Hansen3, Hans-Helmut König4, Jochen Gensichen5, Juliana J Petersen6, Gerhard Schön7, Birgitt Wiese8, Siegfried Weyerer9, Horst Bickel10, Angela Fuchs11, Wolfgang Maier12, Hendrik van den Bussche3, Martin Scherer3, Steffi G Riedel-Heller2. 1. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. Electronic address: Michaela.Schwarzbach@medizin.uni-leipzig.de. 2. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. 3. Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 4. Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 5. Institute for General Practice, Friedrich-Schiller-University Hospital, Jena, Germany. 6. Institute for General Practice, Goethe-University of Frankfurt am Main, Frankfurt am Main, Germany. 7. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 8. Institute for Biometry, Hannover Medical School, Hannover, Germany. 9. Central Institute of Mental Health, Mannheim, Germany. 10. Department of Psychiatry, Technical University of Munich, München, Germany. 11. Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany. 12. Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Abstract
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.
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.
Authors: Marie Dorow; Janine Stein; Alexander Pabst; Siegfried Weyerer; Jochen Werle; Wolfgang Maier; Lisa Miebach; Martin Scherer; Anne Stark; Birgitt Wiese; Lilia Moor; Jens-Oliver Bock; Hans-Helmut König; Steffi G Riedel-Heller Journal: Int J Methods Psychiatr Res Date: 2017-09-25 Impact factor: 4.035
Authors: Luis Agüera-Ortiz; María Dolores Claver-Martín; María Dolores Franco-Fernández; Jorge López-Álvarez; Manuel Martín-Carrasco; María Isabel Ramos-García; Manuel Sánchez-Pérez Journal: Front Psychiatry Date: 2020-05-20 Impact factor: 4.157
Authors: Andrea Zülke; Tobias Luck; Alexander Pabst; Wolfgang Hoffmann; Jochen René Thyrian; Jochen Gensichen; Hanna Kaduszkiewicz; Hans-Helmut König; Walter E Haefeli; David Czock; Birgitt Wiese; Thomas Frese; Susanne Röhr; Steffi G Riedel-Heller Journal: BMC Geriatr Date: 2019-08-01 Impact factor: 3.921