Risk factors for major depression in older medical inpatients: a prospective study.
OBJECTIVE
To determine risk factors for major depression in older medical inpatients.


METHODS
In a prospective cohort study, 86 older medical inpatients without depression or antidepressant medication were assessed 3, 6, and 12 months after enrollment. Incident major depression was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Potential predictive variables included sociodemographic variables, physical state, cognition, depressive symptoms, medication use, prior depressive episode, social network, support, and bereavement. Cox proportional hazards analysis (with backward variable elimination) was used to determine the best set of predictors.


RESULTS
Twenty-six patients (30.2%) met criteria for incident major depression. Predictors of major depression included the following: prior depressive episode, birth outside Canada, low comorbidity, inadequate emotional support, fewer children seen, depressed mood, and diurnal variation. The risk of depression increased with the number of risk factors present.


CONCLUSIONS
The seven identified risk factors may guide efforts to prevent major depression in older medical inpatients.
Cole
Martin G
MG
Department of Psychiatry, St. Mary's Hospital Center, Montreal, Quebec, Canada. martin.cole@ssss.gouv.qc.ca
McCusker
Jane
J
Ciampi
Antonio
A
Belzile
Eric
E
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D002170:Canada / Q000453:epidemiology; D002940:Circadian Rhythm; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D039721:Diagnostic and Statistical Manual of Mental Disorders; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011336:Probability; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012944:Social Support