Factors predicting chronicity of depression in elderly primary care patients.
OBJECTIVE
The aim was to identify the factors predicting and related to chronicity of depression among depressed Finnish elderly subjects.


METHODS
The study consisted of 97 depressed (DSM-III criteria) elderly (60 years or older) Finns treated in primary health care. The occurrence of depression was assessed after treatment and follow-up periods of about 15 months and 5 years, and the persons were classified according to their recovery: (a) persons depressed in all the three examinations (the chronically depressed) (n = 47), and (b) persons depressed in the first examination, but nondepressed in both follow-up examinations (the recovered) (n = 50).


RESULTS
Diurnal variation of symptoms and poor self-appreciation at the baseline and the onset of a severe disease, the deterioration of one's health status, and the death of a family member during the follow-up emerged as independent predictors or associates of the chronic course of depression in the logistic regression model.


CONCLUSIONS
Depressed elderly subjects who develop a physical disease or whose family member dies during the treatment of depression have a high risk for a chronic course. Intensive antidepressant and psychotherapeutic treatment and adequate physical treatment of these patients are proposed, in order to increase the probability of recovery from depression.
University of Oulu, Department of Public Health Science and General Practice, Finland. slk@cc.oulu.fi
S L
SL
Kivelä
P
P
Viramo
K
K
Pahkala
D000368:Aged / Q000523:psychology*; D002908:Chronic Disease; D003289:Convalescence; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006299:Health Services for the Aged / Q000592:standards; D006304:Health Status; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires