title: Twelve-month course of depressive symptoms in older medical inpatients.
abstract: BACKGROUND
  The study aimed: (1) to describe the 12-month course of depressive symptoms among medical inpatients aged 65+, and (2) to investigate predictors of a more severe course that could be identified easily by non-psychiatric staff.
  
  
  METHODS
  Patients were recruited at two Montreal hospitals. Inclusion criteria were: aged 65+, admitted to medical service, at most mild cognitive impairment. Patients were screened for major and minor depression (DSM-IV criteria). All depressed patients and a random sample of non-depressed patients were invited to participate in the prospective study. The Hamilton Depression Scale (HAMD) was administered at admission, 3, 6, and 12 months. Individual patient trajectories of depressive symptoms over time were grouped using hierarchical clustering into three patient groups with a minimal, mild, and moderate/severe course of symptoms, respectively. The baseline predictors of a more severe clinical course were identified using ordinal logistic regression.
  
  
  RESULTS
  Two hundred and thirty-two patients completed baseline and one or more follow-up interviews. Baseline patient characteristics that independently predicted a more severe symptom course included higher initial HAMD score, depressive core symptoms lasting 6 months or more, and female sex.
  
  
  CONCLUSIONS
  The 12-month course of depression symptoms in this medically ill older sample was generally stable. Patients who will experience a more severe course can be identified by non-psychiatric staff at admission to hospital.
authors.affiliation: Department of Clinical Epidemiology and Community Studies, St Mary's Hospital, and Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada. jane.mccusker@mcgill.ca
authors.forename: Jane
authors.initials: J
authors.lastname: McCusker
authors.forename: Martin
authors.initials: M
authors.lastname: Cole
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciampi
authors.forename: Eric
authors.initials: E
authors.lastname: Latimer
authors.forename: Sylvia
authors.initials: S
authors.lastname: Windholz
authors.forename: Michel
authors.initials: M
authors.lastname: Elie
authors.forename: Eric
authors.initials: E
authors.lastname: Belzile
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening; D008609:Mental Status Schedule; D010343:Patient Admission; D010555:Personality Inventory; D011446:Prospective Studies; D011792:Quebec