Using patient-centred consultation when screening for depression in elderly patients: a comparative pilot study.

Area of Science:

• Geriatric Medicine
• Primary Care Psychiatry
• Clinical Screening Tools

Background:

• Validated screening instruments are recommended for detecting depressive symptoms in the elderly.
• Primary care settings require efficient methods for identifying depression in older adults.

Purpose of the Study:

• To compare a patient-centred consultation model with the PRIME-MD screening questionnaire for detecting depressive symptoms in elderly primary care patients.
• To evaluate the diagnostic accuracy of both methods using the MADRS-S as a reference standard.

Main Methods:

• A comparative study was conducted in a Swedish primary care center.
• 302 patients aged 60+ were screened using PRIME-MD and MADRS-S; General Practitioners (GPs) used a patient-centred consultation model.
• Sensitivity, specificity, PPV, and NPV were calculated for both screening methods against MADRS-S at two cut-off levels.

Main Results:

• The PRIME-MD questionnaire demonstrated higher sensitivity (98%) than the consultation model (78%) at a lower cut-off (MADRS-S≥13).
• The consultation model reduced the number of required diagnostic interviews by nearly 50%.
• Both methods showed high sensitivity (93%) and high Negative Predictive Values (NPV) at a higher cut-off (MADRS-S≥20).

Conclusions:

• The patient-centred consultation screening procedure may be as useful in everyday practice as the PRIME-MD screening questionnaire for elderly primary care populations.
• Both screening approaches are valuable for ruling out depressive symptoms in older adults.