Intended for healthcare professionals


Effect of psychogeriatric team on depression in frail elderly people at home

BMJ 1997; 314 doi: (Published 01 February 1997) Cite this as: BMJ 1997;314:377

More information is needed on subjects and interventions in study

  1. Roger Walters, Registrar psychiatrya,
  2. Hilary Evans, Registrar in general practicea
  1. a Psychiatric Wing, Rotherham General Hospital, Rotherham S60 2UD
  2. b Department of Health Care of the Elderly, Medical School, University Hospital, Nottingham NG7 2UH
  3. c Institute of Psychiatry, London SE5 8AF
  4. d Brighton General Hospital, Brighton BN2 3EW
  5. e United Medical and Dental Schools, Guy's Hospital, London SE1 9RT

    Editor–Sube Banerjee and colleagues suggest that intervention by a psychogeriatric team produces a better outcome than standard care by a general practitioner.1 Discussion of their paper in our journal club, however, raised several questions.

    Firstly, from the methodological description in the paper it is not clear whether the general practitioners of the patients and the controls were told that the patients had fulfilled the criteria for caseness for depression or whether they were simply told that the patients were taking part in a controlled trial, with no further details given. This distinction is important for readers to ascertain whether the study simply compared interventions in a group who had been identified as depressed or also included effects of detection or non-detection.

    Secondly, we thought that further data on the interventions in the control group should have been included. It could be argued that it was not the individual interventions themselves but their coordination by a multidisciplinary team that was important in terms of the eventual outcome. It could also be argued that the low rate of use of antidepressants in the control group at follow up was due to the fact that in primary care many patients prescribed antidepressants receive prescriptions of short duration. …

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