Time-to-remission from geriatric depression: psychosocial and clinical factors.
OBJECTIVE
The authors examined psychosocial and clinical predictors of time-to-remission in a sample of initially clinically depressed elderly patients.


METHODS
Using a standardized algorithm, a prospective cohort study enrolled 239 patients undergoing treatment. Patients were followed for up to 4.5 years, until death or withdrawal from the study. Baseline predictor variables included psychosocial factors, such as four domains of social support; basic and instrumental activities of daily living; and clinical factors, including use of electroconvulsive therapy (ECT), past history of depression, comorbidities, and antidepressant treatment.


RESULTS
Only 33% of the sample (n=79) met our classification for depression remission. A lack of instrumental and subjective social support, poor self-rated health, the use of antipsychotic medication, or use of an antidepressant in the last 7 days were predictors of longer time-to-remission. Use of ECT in the last year was related to shorter time-to-remission.


CONCLUSIONS
Baseline psychosocial factors were just as important, as predictors of depression remission, as were clinical and diagnostic variables. Interventions directed toward social support resources, in addition to clinical intervention, including the use of ECT where appropriate, are likely to improve rates of depression remission.
Bosworth
Hayden B
HB
Health Services Research and Development, Building 16, Room 70, Durham Veterans Affairs Medical Center (152), 508 Fulton Street, Durham NC 27705, USA. hboswort@acpub.duke.edu
McQuoid
Douglas R
DR
George
Linda K
LK
Steffens
David C
DC
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011584:Psychology; D012074:Remission Induction; D013997:Time Factors
D000928:Antidepressive Agents