Depression in acutely medically ill elderly inpatients: a pilot study of early identification and intervention by formal psychogeriatric consultation

Background: Depressive disorders are common among acutely medically ill elderly inpatients, but they are poorly recognised and treated. A single blind, randomised and controlled pilot study evaluating the efficacy of early identification of depression and intervention by a psychogeriatric consultation was undertaken. Method: A two-stage screening procedure, using the Geriatric Depression Scale (GDS) and the Brief Assessment Schedule (BAS), was used to identify patients with depression. They were randomised into two groups: one received a psychogeriatric consultation and the other acted as a control group. Patients were followed-up at 10 weeks and 1 year interval. Results: There were no differences between the intervention group and the control group on any outcome measure at 10 week and 1 year follow-up. There was poor concordance between recommended interventions and their implementation by the geriatricians in the intervention group. Also, there were no differences between the intervention and control groups in terms of the interventions received by the patient. The whole sample improved on almost all outcome measures from baseline to 10 weeks and 1 year follow-up. Conclusions: Reasons for the absence of efficacy of psychogeriatric consultation and suggestions for improved methodology are discussed.