The prognosis of major and minor depression in older medical inpatients.
BACKGROUND
Major and minor depression is frequent in older medical inpatients, but the prognosis of these two disorders is not clear. The current study proposed to determine the prognosis of major and minor depression in this population.


METHODS
This prospective, observational cohort study, conducted in Montreal, Quebec, Canada, involved assessment of 380 elderly medical inpatients with major, minor, or no depression at three, six, and 12 months after enrollment using the Diagnostic Interview Schedule and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Information on suicide attempts, completed suicides, and potential prognostic factors was also collected. Analysis of outcomes and potential prognostic factors involved descriptive statistics and multiple logistic regression.


RESULTS
Among patients with major depression at enrollment, 13% were recovered, 14% were partially recovered, and 73% remained depressed with a protracted stable or protracted fluctuating course. Among patients with minor depression, 28% were recovered and 72% had a protracted course. Patients diagnosed with major depression at enrollment often had minor depression at follow up and vice versa.


CONCLUSIONS
The prognosis of both major and minor depression in older medical inpatients is poor and worse than previously thought.
Cole
Martin G
MG
Department of Psychiatry, St Mary's Hospital, Montreal, Quebec, Canada. martin.cole@ssss.gouv.qc.ca
McCusker
Jane
J
Ciampi
Antonio
A
Windholz
Sylvia
S
Latimer
Eric
E
Belzile
Eric
E
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D011379:Prognosis; D011446:Prospective Studies; D011594:Psychometrics; D011792:Quebec; D012720:Severity of Illness Index; D012803:Sick Role; D012944:Social Support; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data