Patient's and general practitioner's different views on patient's depression

Differences between patient's and general practitioner's view on patient's depressive syndromes was investigated in a prospective birth cohort study o f 70 year old people (n = 1032) in Turku City, Finland. The aim of this stu dy was to find factors which are typical for people having depressive syndr omes in old age and help medical and nursing staff to identify depressive s yndromes in the general aged people. The study consisted of a structural po stal questionnaire including patient's perception of his depression, an int erview made by a public health nurse included mini-mental state examination (MMSE) and the self-rating depression scale of Zung, an interview and comp rehensive clinical examination by a general practitioner. Out of the 847 pe rsons who completed the depression test, 12.6% showed symptoms of depressiv e syndrome. The views of those who scored more than 45 points in the Zung d epression scale on their own depressiveness differed from the general pract itioner's opinion. In the general practitioner's examination and interview 58% of the subjects had no depressive symptoms even though the test results indicated that they were depressed. The depressed group stood out most cle arly in two questions: Do you feel you are needed and do you have future pl ans? When the same questions were repeated 5 years later, the difference wa s still statistically significant between depressed and non-depressed group (P < 0.0001). The data indicated that medical and nursing staff should tak e self-assessments seriously and look into them in closer detail. General p ractitioners and nurses should learn to ask right questions and use short d epression scale systematically in order to facilitate the detection of depr essive syndromes. (C) 1999 Elsevier Science Ireland Ltd. All rights reserve d.