Disability associated with depressive symptoms in elderly primary care attenders

Late-life depression is common, disabling and frequently comorbid with physical illness. This study examines a sample of 453 primary care attenders aged 65 years or over. In the screning phase the general health questionnaire-12 (GHQ-12) and the brief disability questionnaire (BDQ) were administered, and the primary care physicians (PCPs) rated the severity of physical illness and recorded the frequency of consultations. PCPs assessed GHQ high scores using the WHO ICD-10 checklist for depression to diagnose ICD-10 defined major episode of depression and subsyndromal depression (SSD), according to Olfson criteria. Mean BDQ score was 5.5 (± 4.9) in non-depressed subjects, 8.8 (± 5.9) in attenders with SSD, and 12.7 (± 5.9) in depressed attenders, with significant differences in each pairwise comparison. Both physical illness and depression independently result in an increased disability and PCP consultation, and when the two conditions are present, they have additive effect. Significant functional impairment is present not only in patients with full-fledged depression, but also in those with just symptoms of depression. Depression and physical illness can negatively ampact each other, resulting in persistent disability and poor prognosis.