Clinical features of depression in the elderly and younger patients at tertiary care center of Saurashtra, India - A comparative study

Abstract

Background: Depression in the elderly has serious consequences such as poor quality of life, dependency, increases comorbidity, and premature death. Symptom profile of depression in the elderly was not extensively researched in India. Objectives: The objective of the study is to compare clinical features of depression between elderly and younger groups and its relation to various sociodemographic variables between two groups. Materials and Methods: A cross-sectional, observational, comparative study carried out at tertiary care center of Jamnagar. Forty patients with depression for each elderly and younger groups were selected using simple convenient sampling from the outpatient department and inpatient department of the Department of Psychiatry, M. P. Shah Government Medical College and Guru Gobind Singh Hospital, Jamnagar. Depression was diagnosed using diagnostic and statistical manual of mental disorder-5 diagnostic criteria for major depressive disorder. HAM-D-17 was used for assessment and comparison of clinical features of depression between two groups. Mini–Mental State Examination used to rule out dementia in elderly patients. Descriptive statistics, t-test, Chi-square test, and binary logistic regression were used for statistical analysis. Results: Symptom profile of depression is somewhat different in the elderly compare to younger patients. Elderly patients with depression compared to young scored significantly less for depressed mood (odds ratio [OR]: 0.98, P = 0.001) and genital symptoms (OR: 0.20, P = 0.038) but significantly higher for somatic symptoms - gastrointestinal (OR: 5.18, P = 0.049) and somatic symptoms - general (OR: 7.06, P = 0.023) and insomnia - delayed (OR: 4.15, P = 0.042). Conclusions: Clinical features of depression are different in the elderly as depressed mood is often masked. Somatic symptoms and insomnia are often reported by elderly depressed patients than younger patients.