Identification and management of late life depression : working across primary care and community service boundaries

In 1990, annual health checks for people aged 75 years and over were introduced into general practice. This was seen as a potential vehicle for systematic screening, with subsequent referral to specialist community services, for older people with depression. Previous research had identified a number of obstacles to the recognition and treatment of late life depression.;This thesis consists of two studies to evaluate the effectiveness of a structured approach by primary care and community services to the identification and management of depression among older people. Phase One was a validation study of the short Geriatric Depression Scale (GDS15) as part of an annual over-75 health check by the practice nurse. A stratified random sample of patients who completed the GDS15 was followed up with a diagnostic interview. At a cut-point of