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Age and Ageing Advance Access originally published online on May 30, 2007
Age and Ageing 2007 36(4):436-442; doi:10.1093/ageing/afm058
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Copyright © The Author 2007. Published by Oxford University Press on behalf of the British Geriatrics Society.

Effectiveness of liaison psychiatric nursing in older medical inpatients with depression: a randomised controlled trial

Sarah Cullum1,, Sue Tucker2, Chris Todd3 and Carol Brayne4

1 Division of Psychiatry, Cotham House, Cotham Hill, Bristol BS6 6JL, UK
2 Personal Social Services Research Unit, University of Manchester, Dover Street Building, Oxford Road, Manchester M13 9PL, UK
3 School of Nursing, Midwifery and Social Work, The University of Manchester, Coupland III Building, Coupland Street, Manchester M13 9PL, UK
4 Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Address correspondence to: Sarah Cullum. Tel: 01454 868327; Fax: 01454 868337. Email: sarah.cullum{at}awp.nhs.uk

Objective: to compare liaison psychiatric nursing with usual medical care in the management of older medical inpatients who screen positive for depression.

Design: pragmatic randomised controlled trial.

Setting: medical wards of UK district general hospital in rural East Anglia.

Participants: one hundred and thirty-eight medical inpatients aged 65+ screened positive on the 15-item geriatric depression scale (GDS). One hundred and twenty-one out of 138 screen positives entered the trial (58/121 fulfilled criteria for depressive disorder at baseline).

Interventions: (i) A liaison psychiatric nurse assessed participants, formulated a care plan for treatment of their depression, ensured its implementation through liaison with appropriate agencies, and monitored participants' mood and response to treatment for up to 12 weeks. (ii) Usual treatment by hospital and primary care staff.

Main outcome measures: ICD-10 depressive disorder, change in GDS-15 score, quality-adjusted life weeks (QALWs) and patient satisfaction rating.

Results: eighty-six out of 121 participants completed the 16-week trial. Participants in the intervention group were more satisfied with their care, but no significant differences in depressive disorder, depression rating or QALWs gained were found between groups. However, there was a trend towards improvement in the intervention group and effect sizes were higher in the subgroup with depressive disorder.

Conclusions: this study is the first RCT to evaluate liaison psychiatric nursing specifically for depression in older medical inpatients; the findings suggest improvement in mental health and quality of life, but a larger trial is required to provide convincing evidence.

Keywords: depression, aged, inpatients, randomised controlled trials, screening, elderly

Received 21 September 2006; accepted in revised form 27 March 2007.


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S. Cullum, C. Metcalfe, C. Todd, and C. Brayne
Does depression predict adverse outcomes for older medical inpatients? A prospective cohort study of individuals screened for a trial
Age Ageing, November 1, 2008; 37(6): 690 - 695.
[Abstract] [Full Text] [PDF]


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