title: Predictors of non-remission of depression in a palliative care population.
abstract: BACKGROUND
  Prospective studies of depression in palliative care are rare. Two studies that examine depression prospectively in patients with advanced disease have not looked at predictors of remission.
  
  
  OBJECTIVE
  to explore prospective predictors of non-remission of depression in palliative care.
  
  
  METHODS
  The study design comprised two data collections: initial assessment on referral to a palliative care service in South London, UK, and a four-week follow-up. Seventy six participants met the criteria for 'any depressive syndrome' at the time 1 assessment, using the PRIME-MD, who also participated at time 2. The outcome measure was remission (N = 39) or non-remission (N = 37) of depression by time 2.
  
  
  RESULTS
  The findings showed that reporting low social support from family and friends at time of referral was the most powerful risk factor for non-remission. There was also a strong association between improved physical symptoms, from time 1 to 2, and remission of depression.
  
  
  CONCLUSIONS
  This study in palliative care is the first of which we are aware to explore factors associated with non-remission of depression. Depressed patients identified with low social support on referral to palliative care services might particularly benefit from additional psychosocial care in the treatment of their depression. This study provides evidence that effective physical symptom management in palliative care may be a valuable intervention for depressive symptoms.
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK. laura.goodwin@kcl.ac.uk
authors.forename: Laura
authors.initials: L
authors.lastname: Goodwin
authors.forename: William
authors.initials: W
authors.lastname: Lee
authors.forename: Annabel
authors.initials: A
authors.lastname: Price
authors.forename: Lauren
authors.initials: L
authors.lastname: Rayner
authors.forename: Barbara
authors.initials: B
authors.lastname: Monroe
authors.forename: Nigel
authors.initials: N
authors.lastname: Sykes
authors.forename: Penny
authors.initials: P
authors.lastname: Hansford
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Higginson
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010166:Palliative Care; D028723:Personhood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D012074:Remission Induction; D012307:Risk Factors; D012944:Social Support; D006113:United Kingdom / Q000453:epidemiology