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Smith R, Meeks S. Screening Older Adults for Depression: Barriers Across Clinical Discipline Training. Innov Aging. 2019;3(2):igz011doi: 10.1093/geroni/igz011.
Smith, R., & Meeks, S. (2019). Screening Older Adults for Depression: Barriers Across Clinical Discipline Training. Innovation in aging, 3(2), igz011. https://doi.org/10.1093/geroni/igz011
Smith, Ronald, and Meeks, Suzanne. "Screening Older Adults for Depression: Barriers Across Clinical Discipline Training." Innovation in aging vol. 3,2 (2019): igz011. doi: https://doi.org/10.1093/geroni/igz011
Smith R, Meeks S. Screening Older Adults for Depression: Barriers Across Clinical Discipline Training. Innov Aging. 2019 May 29;3(2):igz011. doi: 10.1093/geroni/igz011. eCollection 2019 May. PMID: 31187072; PMCID: PMC6541426.
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Innov Aging. 2019 May 29;3(2):igz011. doi: 10.1093/geroni/igz011. eCollection 2019 May.

Screening Older Adults for Depression: Barriers Across Clinical Discipline Training.

Innovation in aging

Ronald Smith, Suzanne Meeks

Affiliations

  1. Department of Psychological and Brain Sciences, University of Louisville, Kentucky.
  2. Geriatric Mental Health, VA Boston Healthcare System, Massachusetts.

PMID: 31187072 PMCID: PMC6541426 DOI: 10.1093/geroni/igz011

Abstract

BACKGROUND AND OBJECTIVES: Depressed older adults are more likely to be seen in primary care than in specialty mental health settings, but research shows that physicians may not routinely screen for depression. Other clinical disciplines are also in a position to screen for depression, but have not been studied. This study examined barriers to screening older adults for depression, and disciplinary differences in clinical trainees' likelihood of screening.

RESEARCH DESIGN AND METHODS: We used a cross-sectional, online survey with experimental manipulation of vignettes. A four-way mixed analysis of variance explored the effects of clinical discipline (between subjects) and time pressure, patient difficulty, and level of symptoms (within subjects) on trainees' likelihood of screening.

RESULTS: Participants were 229 trainees in medicine (83), psychology (51), nursing (49), and social work (46). Lower time pressure and greater symptom severity increased likelihood of screening. There was a significant three-way interaction among discipline, patient difficulty, and symptom level that was driven by social work graduate trainees' greater likelihood of screening for depression when there were more symptoms present, which was diminished if the patient was being difficult. There was a two-way interaction between patient difficulty and level of symptoms: more symptoms resulted in increased likelihood of screening, an effect that diminished with greater patient difficulty.

DISCUSSION AND IMPLICATIONS: The study holds implications for identifying and addressing gaps in education on depression screening to minimize the effects of barriers. Interventions could address education about older adults and depression, including practice-based screening, time management, and behavior management skills.

Keywords: Barriers; Decision making; Depression; Primary care; Screening

References

  1. J Fam Pract. 1999 Dec;48(12):973-9 - PubMed
  2. Int J Geriatr Psychiatry. 2001 Jan;16(1):57-63 - PubMed
  3. Health Expect. 2002 Dec;5(4):282-8 - PubMed
  4. J Psychosom Res. 2003 Apr;54(4):279-87 - PubMed
  5. Am J Geriatr Psychiatry. 2003 Sep-Oct;11(5):517-24 - PubMed
  6. JAMA. 1992 Aug 26;268(8):1018-24 - PubMed
  7. J Gen Intern Med. 1992 Jan-Feb;7(1):26-31 - PubMed
  8. Ann Fam Med. 2004 Nov-Dec;2(6):555-62 - PubMed
  9. Aust N Z J Psychiatry. 2005 Apr;39(4):262-5 - PubMed
  10. Med Care. 2005 Dec;43(12):1217-24 - PubMed
  11. J Gen Intern Med. 2006 Sep;21(9):926-30 - PubMed
  12. Health Psychol. 2006 Nov;25(6):675-7 - PubMed
  13. Psychol Med. 2010 Feb;40(2):225-37 - PubMed
  14. Am J Geriatr Psychiatry. 2010 Jun;18(6):531-43 - PubMed
  15. Int Psychogeriatr. 2010 Nov;22(7):1025-39 - PubMed
  16. Psychother Psychosom. 2010;79(5):285-94 - PubMed
  17. J Affect Disord. 2011 Mar;129(1-3):126-42 - PubMed
  18. Psychiatr Clin North Am. 2011 Jun;34(2):469-87, ix-x - PubMed
  19. Age Ageing. 2012 Mar;41(2):183-90 - PubMed
  20. Practitioner. 2014 May;258(1771):19-22, 2-3 - PubMed
  21. Int J Geriatr Psychiatry. 2015 May;30(5):539-46 - PubMed
  22. World Psychiatry. 2015 Feb;14(1):74-81 - PubMed
  23. JAMA. 2016 Jan 26;315(4):380-7 - PubMed
  24. Psychiatr Serv. 2017 May 1;68(5):449-455 - PubMed
  25. Psychiatr Serv. 2017 Jul 1;68(7):660-666 - PubMed
  26. Psychiatr Serv. 2017 Jul 1;68(7):724-726 - PubMed
  27. Int J Geriatr Psychiatry. 2018 Jan;33(1):e40-e48 - PubMed
  28. Med Clin North Am. 2017 Jul;101(4):807-821 - PubMed
  29. Am J Geriatr Psychiatry. 2018 Jan;26(1):107-122 - PubMed
  30. J Am Assoc Nurse Pract. 2018 Jul;30(7):406-411 - PubMed
  31. Int J Clin Health Psychol. 2015 May-Aug;15(2):160-170 - PubMed
  32. JAMA. 1997 May 28;277(20):1618-23 - PubMed
  33. Arch Fam Med. 1997 Sep-Oct;6(5):433-8 - PubMed
  34. Int J Psychiatry Med. 1997;27(3):185-204 - PubMed
  35. Health Serv Res. 1998 Oct;33(4 Pt 1):891-910 - PubMed

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