Niveditha Vasireddy, Arudhra Gopalakrishnan, Ganesan Gopalakrishnan
BACKGROUND As the population is ageing, many of the older adults will experience depressive disorders. Projections are that, by the year 2020, depression will be second only to heart disease in its contribution to the global burden of disease. In older adults, several environmental challenges can potentially trigger the onset of depression. The depressive symptoms in the elderly are often wrongly thought to be a part of the normal ageing process. Depression if left unidentified, can worsen the physical co-morbidities; again, the physical co-morbidities can lead to depression or worsen already existing un-identified depression. They do not often seek the help of a psychiatrist due to lack of awareness and the associated stigma. Hence, the General Medicine Outpatient department of a Hospital provides an important setting for the detection of depression in the older adults. The objectives of the study were 1) To identify the presence of depression among the patients aged 60 years and above coming to a General Medicine OPD as their first point of contact. 2) To assess the severity of the depression in such elderly. 3) To correlate the depressive symptoms in the said elderly with the existing medical co-morbidities. MATERIALS AND METHODS The elderly subjects aged 60 years and above, visiting the general medicine OPD of MVJ Medical College and Research Hospital were recruited for the study. One hundred consecutive elderly meeting the inclusion criteria were included after excluding those meeting the exclusion criteria. A detailed history was taken, physical and mental state examination was done. Details were collected in the socio-demographic and medical co-morbidity schedule after cross-verifying with a reliable and adequate informant. The Geriatric Depression Scale-15 was then administered. Results were calculated using the SPSS 11.0 version. Results were recorded in the form of means, standard deviations, frequencies, percentages, chi square, p value, t test and one-way ANOVA where applicable. RESULTS 62% of the elderly were found to have significant depressive symptoms which is a large number. When we looked at the severity of depression; 58.06% had mild, 25.80% had moderate and 16.12% had severe, depressive symptoms. Considering that the majority had mild depression, it could easily be overlooked and go undiagnosed. There was no statistical significance between both the groups of depressive symptoms (present/absent) with regards to number of medical co-morbidities. However, when multiple co-morbidities were present, the mean GDS-15 score was found to be higher when compared to none and single co-morbidity.
