title: Double depression in older adult psychiatric outpatients: hopelessness as a defining feature.
abstract: BACKGROUND
  There is a paucity of research on the distinguishing features of double depression, particularly in older adults. Preliminary studies have revealed that individuals with double depression diagnoses tend to have more severe depression than individuals with major depression or dysthymia alone, but few other distinctions between the diagnostic categories have been found.
  
  
  METHODS
  We examined the possibility that hopelessness particularly characterizes double depression, by comparing older adults with double depression, dysthymia alone, or major depression alone, on hopelessness, as well as on internal and external locus of control. The sample included 54 older psychiatric outpatients who completed a battery of cognitive and symptom measures, and underwent structured clinical interviews.
  
  
  RESULTS
  Double depressed patients showed high levels of hopelessness, whereas patients with either major depression or dysthymia alone showed more moderate levels of hopelessness. Low internal locus of control characterized both groups with a dysthymia diagnosis (dysthymia alone and double depression), and differentiated them from the group with major depression alone.
  
  
  CONCLUSIONS
  The sample size was modest, and the results may not generalize to older adults with different demographic characteristics.
  
  
  CONCLUSIONS
  Hopelessness may be important in understanding the phenomenology of double depression in older adults, and may inform diagnostics and psychotherapeutics as well.
authors.affiliation: Department of Psychology, Florida State University, Tallahassee, Florida 32306-1270, United States. joiner@psy.fsu.edu
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Joiner
authors.forename: Joan M
authors.initials: JM
authors.lastname: Cook
authors.forename: Michel
authors.initials: M
authors.lastname: Hersen
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Gordon
mesh_terms: D000368:Aged; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003937:Diagnosis, Differential; D019263:Dysthymic Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010555:Personality Inventory