A daily diary study of late-life depression.
OBJECTIVE
The objective of this study was to use data from daily diaries to characterize the day-to-day variability in positive and negative affects, and the relationship between daily events and daily affects in primary care patients with late-life depression.


METHODS
Daily diary data were obtained from primary care patients with major depression (N = 25) and other depressive disorders (N = 33); data from a two-week period were compared with those from elderly normal volunteer comparison subjects (N = 70) who participated in other studies.


RESULTS
There was significant day-to-day variability in negative affect in patients with major depression and other depressive disorders. Dysphoric days (days with a negative affect ratings that occurred once every two weeks in normal subjects) represented 65.3% (standard deviation [SD]: 37.1) of days in those with major depression and 50.6% (SD: 37.6) in those with other depression versus 7.7% (SD: 16.3) in normal subjects (F = 36.0, p <0.001). The groups did not differ significantly in the number of positive and negative events reported, but the proportion of dysphoric days that occurred in association with negative events was greater in normal subjects than in those with major depression. Mixed-effects analyses demonstrated that patients with major depression had blunted positive affective responses to positive events, consistent with impairments in hedonic processes, and that patients with other depressions exhibited heightened negative affective responses to negative events, greater than those in normal subjects and patients with major depression.


CONCLUSIONS
Diary methods demonstrated characteristics of late-life depression that have not been identified with assessment methods that have lower time resolution.
Chepenik
Lara G
LG
Department of Psychiatry, University of Pennsylvania, Philadelphia, 19104, USA.
Have
Thomas Ten
TT
Oslin
David
D
Datto
Catherine
C
Zubritsky
Cynthia
C
Katz
Ira R
IR
D000339:Affect; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D000368:Aged; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000706:statistics & numerical data; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D015337:Multicenter Studies as Topic; D009341:Negativism; D010414:Pennsylvania; D010555:Personality Inventory; D016032:Randomized Controlled Trials as Topic; D012016:Reference Values; D015203:Reproducibility of Results; D013223:Statistics as Topic; D013315:Stress, Psychological / Q000150:complications