Depressive symptoms and general hospital care in the elderly A population-based study

Depressive symptoms, physician visits and hospitalization among community-dwelling older adults

BACKGROUND

The relationship between depressive symptoms and health service use among older people is not well understood. In this study we examined the two-way relationships between depressive symptoms and hospitalization and/or physician visits by older adults.

METHODS

In a one-year follow-up study of 973 community-dwelling older adults in the Singapore Longitudinal Aging Studies (SLAS), depressive symptoms (15-item Geriatric Depression Scale score > or =5) were assessed at baseline and one year later. Information on self-reported physician visits and hospitalization were collected bimonthly over one year.

RESULTS

When demographic characteristics, medical comorbidities, functional status and other covariates were controlled for, baseline depressive symptoms were associated with increased episodes of subsequent physician visits during the one-year follow-up (RR,1.34; 95% CI, 1.05-1.70), but not with subsequent hospitalization(s) during the same period. Conversely, participants with five or more physician visits (versus less than 5) over one year were more likely to be depressed at one year (OR, 10.2; 95% CI, 3.36-31.1); hospitalization during this period was also significantly associated with depressive symptoms at one year (OR = 6.43, 95% CI, 2.48-16.6).

CONCLUSION

Depressive symptoms and health service use have reciprocal relationships. Health service use for non-mental illnesses may be optimized by efforts at post-hospitalization interventions to recognize and treat depression in older persons.

Common mental disorders and use of general health services: a review of the literature on population-based studies

OBJECTIVE

To review population-based studies on the association between common mental disorders and the use of general (non-mental) health care services.

METHOD

Literature search in Medline and PsychLit databases. Only studies with a prospective design and correction for somatic morbidity were included for review.

RESULTS

On the most general level of outcomes considered and in the majority of studies, mental disorders were associated with higher service use. This general tendency is not consistently reflected in the use of specific health care services, but is materialized in different patterns of out-patient and in-patient service utilization, which vary from study to study. Findings for the elderly were less clear-cut than for other age groups.

CONCLUSION

Mental disorders are related to higher general health care service use on a global, aggregated level. These associations are not specific for certain types of services.