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Determination of the Prevalence of Depression among the Elderly using the Geriatric Depression Scale

Mary Grace T. Valentin1*, Karla Mae D. Aguirre1, Kristina O. Ante1, Carlos Miguel Calderon1, Andrea
Tracy G. Cunanan1, Hannah Lorraine O. Lim1, Funny Jovis P. Malasan1, Katrina Chelsea B. Manlutac1,
Danielle Ann N. Novilla1, Marianne R. Oliveros1, Edwin Monico C. Wee1 and Peter F. Quilala1

1 University of Santo Tomas, Faculty of Pharmacy, Philippines

Background: Geriatric mental health is emerging as an acute public health concern. In the older
population, mental disorders, such as depression,can significantly affect one’s physical health and
prognosis of a disease. Depression, a silent disorder, largely remains untreated because health
assessment is generally focused on the physical medical conditions of patients. This study sought to
determine the incidence of depression in the geriatric population of an elderly community in Quiapo,
Manila, Philippines. Materials and Methods: A descriptive, cross-sectional study of 35 subjects that are
part of the geriatric population (52 years old and above) in St. John of God Elderly Association, was
conducted via survey using the Geriatric Depression Scale Form (GDSF). On August 9, 2014, all the
respondents were interviewed using the GDSF. The questionnaire consists of 15 close-ended questions
and there are corresponding points for each answer. A total of greater than five implies depression of the
elderly subject. The respondents are predominantly female (34 females and 1 male) with a mean age of
67.2 years old. Results: Only 31.43% (11 out of 35) exhibited GDSF scores that are greater than five (5)
which indicates depression. Results show that the incidence of depression occur in 11 out of 35
respondents (31.43%). Symptoms of depression are infrequent among Filipino geriatrics in the selected
community in Quiapo, Manila. Still, in the study, the GDSF proved to be an accessible tool in the
assessment of depression.

References

Anxiety and Depression Association of America. (2015). Depression. Retrieved from:

http://www.adaa.org/understanding-anxiety/depression

Centers for Disease Control and Prevention. (2015). Retrieved from

http://www.cdc.gov/aging/mentalhealth/depression.htm on September 25, 2015

Greenberg, S. (2012). The Geriatric Depressions Scale (GDS). Try This: Best Practices in Nursing

Care to Older Adults (4). Retrieved from on http://consultgerirn.org/uploads/File/

Josef, C. (2014, October 12). Prevalence of depression in the Philippines. Business Mirror. Retrieved from:
http://www.businessmirror.com.ph/prevalence-of-depression-in-the-philippines/

World Health Organization. (2015). Mental health and older adults. Retrieved from:

http://www.who.int/mediacentre/factsheets/fs381/en/
Keywords: Depression, Geriatric Depression Scale, Geriatric population, Prevalence, Mental Health
Conference: ASP2015 - 25th Annual Conference of the Australasian Society for Psychophysiology, Sydney,
Australia, 2 Dec - 4 Dec, 2015.

Presentation Type: Poster Presentation

Topic: Psychophysiology

Citation: Valentin MT, Aguirre KD, Ante KO, Calderon C, Cunanan AG, Lim HO, Malasan FP, Manlutac KB,
Novilla DN, Oliveros MR, Wee EC and Quilala PF (2015). Determination of the prevalence of depression
among the elderly using the Geriatric Depression Scale. Front. Hum. Neurosci. Conference Abstract:
ASP2015 - 25th Annual Conference of the Australasian Society for Psychophysiology. doi:
10.3389/conf.fnhum.2015.219.00059

Received: 18 Nov 2015;

Published Online: 30 Nov 2015.

* Correspondence: Ms. Mary Grace T Valentin, University of Santo Tomas, Faculty of Pharmacy, Manila,
NCR, 1008, Philippines, valentin.marygrace@gmail.com

(REFERENCE : https://www.frontiersin.org/10.3389/conf.fnhum.2015.219.00059/2946/ASP2015_-
_25th_Annual_Conference_of_the_Australasian_Society_for_Psychophysiology/all_events/event_abstra
ct)

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BUSINES MIRROR

Prevalence of Depression in the Philippines

By Cheridine P. Oro-Josef, MD, FPAFP, FPCGM - October 12, 2014

DEPRESSION in the elderly is an important health concern worldwide. It is a silent disorder that afflicts
many of the elderly population. It is the most common psychiatric disorder among the elderly yet
unrecognized and under treated because attention is often focused on the physical medical conditions
that are apparent during clinic visit.
Typical signs and symptoms of depression are usually absent (such as lack of energy, loss of appetite,
constipation, no interest in work, poor sleep or loss of weight) and are masked by physical
manifestations of co-morbid conditions.

In community practice, case reports of elderly suffering from depression were regarded as consequences
of the aging process. Contrary to this belief, depression in the elderly is not physiologic. It is a pathologic
condition that is reversible with prompt and appropriate treatment. Failure to recognize and treat
depression increases the risk of a prolonged course of depressive illness, as well as other conditions like
malnutrition, significant metabolic illnesses, and a greater chance of dying.

The elderly population in the Philippines (adults aged 65 years and older) numbered 2.12 million in 1990
(UN 1991). In absolute numbers, the elderly Philippine population is close to that of Thailand and much
more numerous than in Singapore or Malaysia.

Aging trends in the Philippines have been consistently slower compared to other Southeast Asian
countries. In 1970 the elderly comprised 2.7 percent of the total Philippine population, increasing to 3.6
percent in the 1990s. The elderly population (age 60 and above) has doubled in number since the 1970s
and could triple in this decade. It may reach the 10-percent mark before 2020 which may eventually
categorize it as an aging population.

The results of an international study conducted by the World Health Organization showed that the
prevalence rate of depression worldwide ranged from 2.6 percent to 29.5 percent. In a survey
conducted by Perlas, Tronco et al in the Philippines, about 5.3 percent of the subjects were suffering
from depression.

A similar study we conducted in the province of Rizal using the Geriatric Depression Scale (Short Form)
showed a 6.6-percent rate of depression. This prevalence rate among the elderly in the most populated
province of the Philippines shows that depression can be present in healthy Filipino communities.

However, it is considerable to note that a fourth (26.5 percent) of the population has scores suggestive of
depression. This is a window for early intervention in the community level. Depression has been found to
be associated with poorer prognosis, longer recovery times from illness and increased health-care
utilization.
Screening the elderly population for possible depression therefore is important to decrease health-care
utilization and increase wellness for this age group. It is necessary for primary-care physicians,
geriatricians and caregivers to identify symptoms of depression in patients with scores suggestive of
depression to avoid the development of outright depression.

REFERENCE : https://businessmirror.com.ph/prevalence-of-depression-in-the-philippines/

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Health News

Millions suffering from depression in PH – DoH, WHO

April 6, 2017 9:28 pm

(Reference : http://beyonddeadlines.com/2017/04/06/million-of-people-in-ph-suffering-from-
depression-doh-who/)

MORE than 3.29 million people in the Philippines are living with depression and an almost equal number
of individuals are suffering from anxiety.

This was learned Friday as the Department of Health (DOH) and the World Health Organization–
Philippines (WHO-PH) calls on everyone – the public, private, and civil society sectors – to engage in a
“serious national chat” using multi-media platforms to understand depression and other mental health
problems burdening millions of Filipinos.

The WHO-PH’s latest global statistics said that more than 300 million people are battling depression, or
an increase of more than 18 percent during the period 2005-2015.
In the Philippines alone, it is estimated that 3.29 million people are living with depression and that 3.07
million are be living with anxiety. Depression is a leading factor in suicide.

Echoing the WHO declaration on World Health Day 2017 that “depression is the leading cause of ill
health and disability worldwide,” Health Secretary Paulyn Jean B. Rosell Ubial and Dr.Gundo Weiler, WHO
representative in the Philippines, agreed that “it is urgent and imperative that new approaches to engage
every Filipino in a serious national chat on depression must lead to more openness in discussing
depression, demystification of depression, and eventually the de-stigmatization of depression and other
mental health issues.”

Sec. Ubial noted that in the Philippines “depression must be acknowledged as the quiet crawling and
menacing killer, which debilitates and traps millions of Filipinos daily in an invisible but merciless web of
desperate existence.”

“The first and important step toward understanding depression is encouraging discussion between two
persons or among people within a group, in a safe and trusting environment, about the pangs and pain
of depression,” she said.

Ubial stressed that “In view of this, homes, schools, and offices are key sites in starting a serious national
chat in understanding depression and other mental health issues.”

“With proper, adequate health support or treatment, people with depression and other mental health
problems can become productive members of our society. We must act now to destroy decisively this
web of deadly despair and discomfort,” Ubial said.

“On top of stigma and prejudice surrounding depression, we must acknowledge and act on the lack or
inadequate funding in treating people with depression and other mental health problems,” she added.
For its part, the WHO-PH said that among the factors hampering people with mental health issues to
seek and access needed treatment are the lack of support for people with mental disorders and the fear
of stigma.

“The World Health Day 2017 campaign is about depression, an illness that affects people of all ages,
from all walks of life, in all countries. The overall goal of the campaign is that more people with
depression, in all countries, seek and get help,” Weiler said.

Moreover, Weier said “Now is the time to initiate a serious national chat in our own small circles of
friends and colleagues to better grasp what is depression. Talking about depression is the first single
biggest step toward its treatment, management, recovery, and the subsequent and substantial
improvement of the quality of daily life of many people around us struggling with depression and other
mental health issues.”

He also appealed that “we must do everything possible to decisively turn the tide and end the cycle that
has allowed depression to evolve into a silent epidemic and unseen killer that now ranks as among the
top causes of serious disability and serious illnesses.”

As the highlight of the Philippine participation in the World Health Day 2017, the WHO-PH sponsored the
staging by Twin Bill Theater of the award-winning play “Suicide, Inc.” on April 7 at the St. Paul University
– Manila campus, with students and young adolescents as the primary target audience of the
information and education activity via stage play.

Directed by Steven Conde, the cast for the special performance sponsored by the WHO-PH were: Mako
Alonso, Raymund Concepcion, Bibo Reyes, Edrei Tan, and Chino Veguillas.

The audience for the special staging of “Suicide, Inc.” were led by Ubial, Weiler, officials of the St. Paul
University – Manila and their students, who were joined by students from academic institutions in
Manila.

“Suicide, Inc.” is a 2010 tragicomedy by celebrated off-Broadway playwright Andrew Hinderaker, with the
plot revolving around Legacy Letters, a company that makes money by drafting or editing suicide notes.
The Twin Bill Theater production of “Suicide, Inc.,” a play tackling sensitive, if not taboo, issues is aimed
at encouraging more people to talk about depression and mental health.

The production is the WHO-Philippines, DOH, and Twin Bill Theater’s contribution to the efforts to get
more Filipinos to be more open and honest in discussing mental health concerns such as depression,
suicidal ideation, suicide attempts, and other mental health issues.

Others : https://abalancingact11.wordpress.com/2018/05/05/depression-and-mental-health-care-in-
the-philippines-an-infographic/

******************

Hopeline and depression

According to the World Health Organization (WHO), more than 100 million people suffer from mental
disorders in the Western Pacific region, including in the Philippines, with depressive disorders accounting
for 5.73% of mental disorders in the region.

Globally, more than 300 million people are now living with depression, the leading cause of ill health and
disability worldwide.

In 2004, over 4.5 million cases of depression were reported in the Philippines, according to the
Department of Health (DOH) – but that number is likely to be much higher, since many of those suffering
from depression hesitate to seek help because of the stigma still surrounding mental disorders.

Those suffering from depression also don’t exhibit the symptoms more obviously compared to those
suffering from psychotic disorders like schizophrenia, where the symptoms are much more noticeable
and tend to be perceived as more severe.
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Not so in the case of depression.

“There’s poor help-seeking behavior for depression, because people don’t see the person’s ‘disturbed’
behavior,” said Dinah Nadera, psychiatrist and president of non-governmental organization Foundation
Awit.

“People see that this person is sad and not doing much because he’s losing interest in the things he used
to enjoy. They don’t understand that this person is depressed and not simply lazy,” she said.

One positive step toward helping address depression was the launch of Hopeline in 2016.

Of the 3,479 calls received by the 24/7 crisis support hotline, 605 came from people who admitted to
being depressed, while 496 people needed information on depression and suicide. Another 479 called
because of stress or possible depression, while 111 people admitted being suicidal.

While mental health advocates laud the crisis hotline for being a step in the right direction, its
implementation leaves room for improvement. Earlier this year, Hopeline drew flak from netizens who
complained about apathetic crisis responders and the inaccessibility of the 24/7 hotline beyond business
hours. (READ: Philippines' suicide hotline draws flak for alleged inaccessibility)

It is also limited for now to answering calls and questions, and referring patients to mental health
professionals.

But not all mental healthcare facilities are readily accessible and available to callers referred by Hopeline.
For instance, the operator might want to refer the caller to the nearest hospital with mental health
services – but that hospital may still be too far away, especially if the caller is from the provinces.
Adding to the problem is the lack of psychiatrists in the country. The Philippines has only one psychiatrist
for every 250,000 population, far from the ideal ratio of one psychiatrist to 50,000 population

Community-based services

In a bid to augment this gap, the government is scaling up its community mental health program, and
training city and municipal health officers to identify mental health problems among their patients.

The idea is that general practitioners should be able to assess their patients’ mental health needs,
identify possible problems and make diagnoses for basic mental health problems. More advanced or
specialized cases can be referred to trained psychiatrists.

This community-based program was piloted in 2013, following the destruction caused by Typhoon
Yolanda (Haiyan) across the central Philippines.

The WHO trained local health workers in psychological first aid to help survivors recovering from the
trauma of losing their homes and loved ones in the aftermath of the worst typhoon to hit land.

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