EPA-0196 – A Case Series of Depressed Elderly (>64 Years) Presenting in a General Hospital in Singapore

Abstract

Introduction:

A recent national survey highlighted the considerable treatment gap for depression (59.6%) in modern Singapore. Asians tend to focus on physical features of a disease than the psychological ones, which might contribute to the relative lack of disease pick up by physicians. Literature suggests a distinct clinical entity of depression among the elderly, with a different clinical presentation from adults.

Objectives:

This retrospective case series was undertaken to understand the clinical features and management decisions of elderly patients presenting with depression in Singapore.

Aims:

To describe the demographics, clinical presentation, psychiatric and medical co-morbidities, and management decisions of depression in the elderly.

Methods:

Inter-departmental referrals to the Department of Psychological Medicine of Tan Tock Seng Hospital from 1/1/2011 to 31/3/2011 for the management of patients ages above 64 with the diagnosis of depression were collated for case description.

Results:

A total of 40 inpatients ages 64 to 101 years (mean 75.7 years) were recruited. 15 (37.5%) were male and 25 (62.5%) were female. 22 (55.0%) have an existing diagnosis of depression. 28 (70.0%) of the patients were referred for review of symptoms of depression. The most prevalent symptoms were low mood (67.5%), followed by biological symptoms of depression (47.5%), and suicidal thoughts (37.5%). 23 (57.5%) of the patients were started on Selective Serotonin Receptor Inhibitors.

Conclusion:

As the population of Singapore ages, clinicians should be mindful that depression often co-exist with medical co-morbidities, and the complex interaction amongst the two entities.