[Prevalence and diagnosis of depression in frail nursing home patients; a pilot study]

The prevalence and recognition of depression among physically frail patients living in an urban Dutch nursing home were estimated. To patients with Mini-Mental-Status-Examination (MMSE) scores of 15 or above, the Geriatric Depression Scale (GDS) was administered (N = 80). With this screen clinically relevant depressive symptoms can be established. For diagnosing major depression according to the DSM-IV criteria, the Diagnostic Interview Schedule (DIS) (N = 57) was administered using a MMSE cut-off of 20. 49% of the respondents showed a score above the GDS cut-off (> 11), which means having clinically relevant depressive symptoms. 16% met the criteria for major depression according to DIS. Nursing home physicians recognized 39% of the patients with clinically relevant depressive symptoms and 67% of those with a major depression. Nurses recognized depressive patients slightly better but they were less specific in their judgement (more false-positive rates). We also found that in situations in which physicians and nurses had the same opinion the recognition of depression improved. Therefore it is recommended that physicians and nurses exchange their judgements on patients' mood on a regular basis.