Indian Association for Geriatric Mental Health's multicentric study on depression in elderly: Symptom profile and influence of gender, age of onset, age at presentation, and number of episodes on symptom profile

Abstract

Aim of the Study: To assess the symptom profile of depression among elderly patients presenting to psychiatric outpatient settings. An additional aim was to evaluate the influence of gender, age of onset, age at presentation, and type of episode (i.e., the first episode versus recurrent depressive episodes) on symptom profile of geriatric depression. Materials and Methods: This multicentric study was conducted at eight centers in which 488 elderly patients (aged ≥60 years) with depression were evaluated on Geriatric Depression Scale (GDS-30), Generalized Anxiety Disorder-7 Scale (GAD-7), Patient Health Questionnaire-15 (PHQ-15) scale, and Columbia Suicide Severity Rating Scale. Results: Males had significantly higher prevalence of comorbid substance dependence, whereas females had significantly higher prevalence of comorbid psychiatric disorders. As per the GDS-30, about two-third or more of the study sample had symptoms of feeling helpless (71.7%), often getting restless and fidgety (70.1%), dropped many of their activities (68.4%), frequently feel like crying (67.4%), trouble concentrating (67%), feels pretty worthless (66.4%), often feeling downhearted and blue (65.8%), frequently getting upset over little things (64.8%), and not satisfied with life (62.9%). More than two-third of the sample had all the symptoms of anxiety as per the GAD-7 and 7 out of the 14 somatic symptoms as per the PHQ-15. When comparisons were made between males and females, significant difference in prevalence was noted for some of the depressive symptoms as assessed by the GDS-30 and somatic symptoms as assessed by the PHQ-15, but no differences emerged in terms of anxiety symptoms. Significantly higher proportion of females reported active suicidal ideation with specific plan and intent and had higher intensity of suicidal ideations. Differences in symptom profile were also noted with regard to age of onset (<60 and ≥60 years), age at presentation (<70 and ≥70 years), and type of depression (single versus multiple episodes). Conclusion: The present study suggests that somatic and anxiety symptoms are highly prevalent among elderly patients with depression. Further, it is evident that there are certain differences in the symptom profile of depression among male and female patients with depression. The present study also reveals that age of onset, age at presentation, and number of episodes could also influence the symptom profile of depression among the elderly.

Keywords

• Depression
• elderly
• gender
• symptom profile