Objectives
Primary care providers often struggle to identify depression in older individuals, with patients with multiple chronic conditions presenting additional unique challenges. Whilst research has discovered much about clinician experiences with depression patients, there is a paucity of literature surrounding the impact of multimorbidity on the diagnosis and management of depression in primary care.
Methods
Eight GPs with multiple referrals to a multidisciplinary clinic at the Royal Adelaide Hospital engaged in a semi-structured interview to discuss the impact of multimorbidity on the diagnosis and detection of depression. Interviews were transcribed and thematic analysis was used to identify key themes. Grounded theory was generated from data relating to the role of multimorbidity.
Results
Participants described multimorbidity as having both a positive and negative impact on depression diagnosis, and providing a complex treatment context. Positive outcomes included relationship generated from frequent presentations, creating time to identify symptom causation and discuss the subject with the patient. Adversely, multimorbidity obscured symptom causation. Treatment was affected by a range of variables, and included medical and social interventions.
Conclusion
GPs recommend social interventions where medical interventions are perceived as inappropriate. Research into the efficacy of social interventions in multimorbid patients is needed.
Miss Melinda Stanners PhD Candidate University of Adelaide
13th International Mental Health Conference
Positive Change – Investing in Mental Health
6-8 August 2012, The Outrigger Surfers Paradise
The conference will examine state, federal, international and COAG initiatives, early intervention strategies, validated treatments, suicide prevention and the effectiveness of mental health preventive measures. | Visit the website
