Predictors of depression outcomes in medical inpatients with chronic pulmonary disease.
OBJECTIVE
Baseline patient characteristics and depression treatments were examined as predictors of speed of depression remission in hospitalized medical patients with chronic pulmonary disease (CPD).


METHODS
Consecutively admitted patients over age 50 years with CPD were screened for major and minor depression using the Structured Clinical Interview for Depression. Patients with minor depression were followed up over 12-24 weeks with the Longitudinal Interview Follow-up Evaluation. Course of depression and predictors of remission were examined.


RESULTS
Seven hundred eleven depressed patients with CPD (410 with minor, 301 with major depression) were identified and assessed over time. Two-thirds with minor depression had remitted by 12 weeks compared with 26.9% with major depression at 12 weeks and 49.2% at 24 weeks. Predictors of faster remission for minor depression were black race, community hospital admission, less severe depression, less medical comorbidity, less severe CPD, more social support, and no antidepressant treatment. For major depression, less severe depression, no past antidepressant drug treatment, and less intense current antidepressant treatment predicted faster remission.


CONCLUSIONS
The course of depressive disorder after discharge in patients hospitalized with CPD can be predicted by characteristics during admission. Although patients with minor depression may be followed and treatment initiated only if depression persists, those with major depression need more aggressive treatment and psychiatric consultation if improvement does not occur.
Koenig
Harold G
HG
Departments of Psychiatry & Behavioral Sciences and Medicine, Duke University Medical Center, Durham, NC 27710, USA. koenig@geri.duke.edu
D000223:Adaptation, Psychological; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D012075:Remission, Spontaneous; D012803:Sick Role; D012944:Social Support
D000928:Antidepressive Agents