Synchronous Epidemiology of Unobserved Clinical Depression in Institutionalised Elder People


OBJECTIVE: To assess the preponderance and affiliated components of unobserved clinical depression in institutionalised elder people.

DESIGN AND SETTING: Epidemiologic cross-sectional report in rest homes and residential facilities.

PARTICIPANTS: A hierarchical cluster sampling of occupants 65 years of age and older living in psychiatric hospitals of Madrid (Spain).

MEASUREMENTS: Residents were thought to be depressed if they conformed to at least 1 of the succeeding 3 measures: 10-item Geriatric Depression Scale grade of 4 or greater, physician's diagnosis, or antidepressant drug utilization. Preponderance of unobserved clinical depression was delineated as the proportion of depressed occupants without authenticated diagnosis or discourse.

RESULTS: A sum of 255 of 579 residents had clinical depression (adjusted preponderance 46.1%, 95% sureness interval [CI] 41.0%-51.3%) and 108 depressed residents were unobserved (undetection preponderance 41.5%, 95% CI 33.2%-50.2%). Undetection was more reduced in younger occupants, private versus public facilities (sex-, age-, and size-adjusted preponderance ratio [PR] 0.59, 95% CI 0.37-0.94), and bigger facilities (sex-, age-, and ownership-adjusted PR 0.94 per 50-bed increment, 95% CI 0.88-1.00). Unobserved clinical depression was broader in occupants with deficient self-rated wellness (sex- and age-adjusted PR 1.83, 95% CI 1.24-2.73), whereas the inverse occurred for physician-rated wellness (PR 0.65, 95% CI 0.44-0.95). Undetection diminished 11% (95% CI 4%-17%) per 1-medication increment, and it was smaller in patients with Alzheimer disease, anxiousness, and cardiac arrhythmia.

CONCLUSIONS: amount of medicines and self-rated wellness comprised the chief determinatives of unobserved clinical depression. Physician-rated healthcare facility features (size and ownership), and many diseases may likewise be studied.




“Under the care of Leo J. Borrell, M.D. since December 2001, I have seen a remarkable improvement in my mother’s condition. She is responding dramatically to the new regiment Dr. Borrell has prescribed”

- Beth Rose


Feb 3, 2008

The Interdisciplinary Team; The Role of the Psychiatrist

by Dr. Leo J. Borrell, featured in Assisted Living Consult for November/December 2006. A HealthCom Media Publication