Intended for healthcare professionals


Outcome of depression in later life in primary care: longitudinal cohort study with three years’ follow-up

BMJ 2009; 338 doi: (Published 02 February 2009) Cite this as: BMJ 2009;338:a3079

'Depression is underdiagnosed and undertreated'- Are governments listening?

The study findings of Licht-Strunk and colleagues (1) again reinforce
the scientific literature that 'Depression in elderly community and
primary care populations has a poor prognosis, is perhaps chronic or
relapsing or both, and is probably undertreated'(2).

Depression is a major contributor to healthcare costs associated with
older populations, and is projected to be the leading cause of disease
burden in elderly (3). Despite these facts, geriatric depression remains
undiagnosed or under-diagnosed, and sadly undertreated in primary care
(4), here 'as most (60% of patients with major depressive disorder at
baseline, 71-77% during follow-up) did not receive any treatment for their
condition' (1). It also reflects that despite the advancement of health
services, treatment of older adults is lagging behind even in developed

Health policy makers should look this disease burden and modify and
strengthen training programs for primary care physicians. They also
incorporate free treatment options for these older adults. Governments
must wake to defeat depression in all age groups, including elderly.


1.Licht-Strunk E, Van Marwijk HWJ, Hoekstra T, Twisk JWR, De Haan M,
Beekman ATF. Outcome of depression in later life in primary care:
longitudinal cohort study with three years' follow-up. BMJ 2009; 338:

2.Cole MG, Bellavance F, Mansour A. Prognosis of depression in
elderly community and primary care populations: a systematic review and
meta-analysis. Am J Psychiatry. 1999 Aug;156(8):1182-9.

3.Katon WJ, Lin E, Russo J, Unutzer J. Increased medical costs of a
population-based sample of depressed elderly patients. Arch Gen Psychiatry

4.Prakash O, Gupta LN, Singh VB, Nagrajarao N. Applicability of 15-
item Geriatric Depression Scale to detect depression in elderly medical
outpatients. Asian J Psychiatry 2009; 2(2): 63-65.

Competing interests: No competing interests

30 June 2011
Om Prakash
Associate Professor of Psychiatry, Consultant in Adult & Geriatric Psychiatry
Institute of Human Behaviour & Allied Sciences (IHBAS), New Delhi, INDIA