In a study of 59 elderly medically ill in-patients, 35% were found to have significant depressive symptomatology, as detected by the Geriatric Mental Status Schedule (GMSS). Of two screening methods, the Geriatric Depression Scale (GDS) performed satisfactorily but detection by nurses was poor. Acknowledgement of depression in medical casenotes was low. Training of nurses might improve detection; otherwise a mood-rating scale such as the GDS should be incorporated into routine practice.