title: Incidence and outcome of depressive symptoms in nursing home patients in the Netherlands.
abstract: OBJECTIVE
  To assess incidence and outcome of depressive symptoms among nursing home (NH) patients and to identify clinical characteristics predicting onset and persistence of depressive symptoms.
  
  
  METHODS
  Depressive symptoms (GDS>10) and relevant correlates were assessed at baseline and at follow-up (6 months) in 350 NH-patients of 14 Dutch NH's with the Geriatric Depression Scale (GDS). Predictors of onset and persistence were studied using chi-square statistics and multiple logistic regression analyses.
  
  
  RESULTS
  The prevalence of depressive symptoms decreased from 41.3% to 28.9% during six months follow-up. The onset of depressive symptoms in those without depressive symptoms at baseline was 4.7%, while the rate of persistence was 63.3%. Persistence of depressive symptoms was more frequent in patients with higher GDS-scores (18-30) at baseline. No baseline characteristics were associated with onset of depressive symptoms. Persistence of depressive symptoms was only associated with more years of education.
  
  
  CONCLUSIONS
  Pre-admission factors and transition may largely be responsible for depressive symptoms among nursing home patients. The observed substantial decrease in prevalence of depressive symptoms over six months is largely due to remission of depressive symptoms present at baseline. Adaptation of nursing home patients to pre-admission factors, facilitated by the nursing home environment, may explain this observed decrease of depressive symptoms. Future studies should evaluate interventions targeted at patients with higher GDS-scores (18-30).
authors.affiliation: Department of Nursing Home Medicine, VU University Medical Center, Amsterdam, The Netherlands. m.smalbrugge@vumc.nl
authors.forename: Martin
authors.initials: M
authors.lastname: Smalbrugge
authors.forename: Lineke
authors.initials: L
authors.lastname: Jongenelis
authors.forename: Anne Margriet
authors.initials: AM
authors.lastname: Pot
authors.forename: Jan A
authors.initials: JA
authors.lastname: Eefsting
authors.forename: Miel W
authors.initials: MW
authors.lastname: Ribbe
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000453:epidemiology* / Q000628:therapy*; D003866:Depressive Disorder / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006707:Homes for the Aged; D006801:Humans; D015994:Incidence; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes; D012044:Regression Analysis; D016896:Treatment Outcome