Detection of depression in patients in emergency wards using the GDS-30

Background

The purpose of this study was to use a Greek version of the Geriatric Depression Scale (GDS-30) for diagnosis of depression in the elderly complaining for chest pain in Emergency Department.

Materials and methods

Elderly patients(65 years of age; n = 473), visiting Emergency Department, complaining for chest pain, without coronary heart disease (normal ECG, without elevation of CK-MB and Troponin) were rated by General Practitioner using the GDS-30.Their mean age ± standard deviations was 69.8 ± 7.7 (male 70.1 ± 7.7; and female 68.7 ± 7.5) years.In the first phase, the patients completed the GDS, the Mini-Mental State Examination (M.M.S.E.) and a questionnaire on health and socio- demographic variables. They were interviewed using the Geriatric Mental Schedule (GMS), used by doctor who was unaware of the results of the GDS. Two categories were contemplated according to the results of the GMS: cases of depression (diagnosis of psychotic or neurotic depression) and non-psychiatric cases.

Results

473 aged patients were interviewed using the GDS and the GMS. Of these, 330 were considered non-cases of depression and 143 others made up the cases of psychotic/neurotic depression group. The study population had a high (30%) prevalence of depression.

Discussion

The use of GDS-30 may aid the detection of Depression in patients in Emergency Department where depression in the elderly is under diagnosed.

Only 21% of those with a diagnosis of depression had any mention of mental health problems in their medical notes in the year prior to the clinical interview.

Diagnosis of Depression is more likely if more than two visits for chest pain exists.