Twelve-month course of depressive symptoms in older medical inpatients.
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.
McCusker
Jane
J
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
Cole
Martin
M
Ciampi
Antonio
A
Latimer
Eric
E
Windholz
Sylvia
S
Elie
Michel
M
Belzile
Eric
E
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