Depression in geriatric ED patients: Prevalence and recognition
Depression in geriatric ED patients: Prevalence and recognition
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DOI：
10.1016/s0196-0644(97)70132-x
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发表时间：
1997-08-01
影响因子：
6.2
通讯作者：
Etheart, RG
中科院分区：
文献类型：
--
作者：
Meldon, SW;Emerman, CL;Etheart, RG
研究目的：确定老年ED患者抑郁症的患病率，并评估急诊医生对老年抑郁症的认识。方法：我们对在城市大学附属公立医院急诊科就诊的老年患者进行了一项观察性调查。259名年龄在65岁或以上的患者进行了简短的自评抑郁量表。主要结果测量是抑郁症的患病率（使用预先确定的检测抑郁症的截止分数）和治疗的急诊医生对抑郁症的认识，通过图表回顾进行评估。结果：70名受试者（27%；95%可信区间[CI]， 22%至32%）被评为抑郁。抑郁症患者和非抑郁症患者在年龄、性别、种族或教育程度上没有显著差异。47%的养老院居民患有抑郁症，而独立生活的人只有24% （95% CI差异为23%，6%至41%）。将自己的健康状况描述为较差的患者（65人中的33人，51%）也比报告自己的健康状况良好或一般的患者（194人中的37人，29%）更容易抑郁（95%置信区间远差32%，18%到45%）。急诊医生未能在该量表中发现的所有抑郁症患者中识别出抑郁症（95% CI, 0 - 5%）。结论：在我们研究的老年ED患者中，未被认识到的抑郁症患病率很高，特别是在那些报告自己健康状况较差的患者中。使用简短的抑郁量表可以帮助识别抑郁症的老年患者，阅读适当的转诊和治疗。
Study objective: To determine the prevalence of depression in geriatric ED patients and to assess recognition of geriatric depression by emergency physicians.Methods: We conducted an observational survey of geriatric patients who presented to an urban, university-affiliate public hospital ED. A convenience sample of 259 patients aged 65 years or older were administered a brief, self-rated depression scale. Main outcome measures were prevalence of depression (using a predetermined cutoff score for detecting depression) and recognition of depression by the treating emergency physician, assessed by chart review.Results: Seventy subjects (27%; 95% confidence interval [CI], 22% to 32%) were rated as depressed. Depressed and nondepressed patients were not significantly different with regard to age, sex, race, or education. Forty-seven percent of nursing home residents were depressed, compared with 24% of those living independently (95% CI for difference of 23%, 6% to 41%). Patients who described their health as poor were also more likely to be depressed (33 of 65, 51%) than patients who reported their health to be good or fair (37 of 194, 29%) (95% CI far difference of 32%, 18% to 45%). Emergency physicians failed to recognize depression in all the patients found to be depressed on this scale (95% CI, 0 to 5%).Conclusion: The prevalence of unrecognized depression in the geriatric ED patients we studied was high, especially in those who reported their health as poor. Use of a brief depression scale can aid recognition of depression in older patients, reading to appropriate referral and treatment.