PATHWAY TO PSYCHIATRIC-CARE OF THE ELDERLY WITH DEPRESSION

Goldberg and Huxley describe a pathway to psychiatric care which has f ive levels and four filters. To explore the application of this pathwa y to the elderly with depression we searched the relevant literature t o estimate median annual rates of moderate-severe depression at each l evel of the pathway, Among 27 elderly per thousand each year who had d epression, 22 consulted a family physician who detected the disorder i n 5.3. Of these, 2.8 were referred to psychiatric services and 1.3 wer e ultimately admitted to psychiatric units. Thus, only 10% of the elde rly with moderate-severe depression were assessed or treated by a psyc hiatrist. If confirmed, these findings have implications for geriatric psychiatry services and research.