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A Journal on Psychiatry, Psychology and Psychopharmacology
Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus
Minerva Psichiatrica 2015 June;56(2):61-9
The role of general practitioners in the management of minor depression and comorbidity in the elderly: development of a symptom checklist for differential diagnosis
Robusto F. 1, 2, Colucci E. 1, Dell’Aquila L. 1, Colucci V. 1, D’Ettore A. 2, Lepore V. 3, Colucci G. 1
1 ASL TA 5, Martina Franca, Taranto, Italia;
2 Istituto Mario Negri Sud, Chieti, Italia;
3 Dipartimento di Neurologia, Università degli Studi di Bari, Bari, Italia
AIM: Diagnosis and management of elderly depressed patients involve more and more general practitioners (GPs), raising questions about clinical judgment criteria. Objective of the study was first to compare the seriousness of illnesses as perceived by GPs with various symptoms/manifestations of possible depressive nature collected in a check-list (CL) formulated by the GPs themselves, to assess which items affect the GPs’ opinion more; then to examine if other factors (social, family, comorbility) modify GPs’ clinical judgment.
METHODS: GPs compiled an electronic-online-form, with: 1) social, personal and clinical data of patients; 2) a 19-item check-list, with a score (1 to 5) for each item; 3) an independent assessment of the depressive syndromes with 3 degrees (light/borderline, moderate, serious).
RESULTS: The study included 242 patients. GPs associated a serious clinical judgment to patients with a high score of the CL (P<0.001); both the GPs’ clinical judgment and the CL’s score were related to comorbidity (assessed with Charlson’s index). Although the suicidal ideation was defined as the most serious symptoms, items related to interests/relationship area affected GPs’ clinical judgment (OR=1.19, P<0.001) more than psychic/somatic symptoms.
CONCLUSION: The experimented CL represents a useful tool to assess and standardize GPs’ clinical judgment, including social and clinical data in the evaluation of severity in elderly depressed patients.