Depression in primary care 1: Elderly patients' disclosure of depressive symptoms to their doctors

Background: This article examines some of the factors responsible for older patients' decision to report current depressive symptoms to their general medical practitioner. A companion article considers factors contributing to general practitioners' (GPs') recognition of major depressive episode when it was present. Methods: A survey was conducted of a stratified sample of 1,021 patients aged 70+ years of 30 GPs in Melbourne, Australia, to gauge t he prevalence of depressive symptoms, the frequency with which patients had informed GPs of their symptoms, and GPs' recognition of major depressive e pisodes. Patients and informants were questioned using the Canberra Intervi ew for the Elderly, which generates rigorous ICD-10 research diagnoses. Res ults: Logistic regression analysis showed that symptom disclosure was assoc iated in descending order of importance with higher depressive scores, prev ious contact with a psychiatrist, and female gender. Even so, 48% of person s with ICD-10 moderate or severe depressive episode had not reported any cu rrent complaints to their doctor at the time of interview. Conclusion: Olde r patients often do not report depressive symptoms to their medical practit ioner. Men and patients lacking "psychological mindedness" may be at specia l risk.