title: Depressive disorder in the last phase of life in patients with cardiovascular disease, cancer, and COPD: data from a 20-year follow-up period in general practice.
abstract: BACKGROUND
  Depression is assumed to be common in chronically ill patients during their last phase of life and is associated with poorer outcomes. The prevalence of depression is widely varying in previous studies due to the use of different terminology, classification, and assessment methods.
  
  
  OBJECTIVE
  To explore the reported incidence of depressive disorder, as registered in the last phase of life of patients who died from cardiovascular disease, cancer or COPD, in a sample of primary care patients.
  
  
  METHODS
  A historic cohort study, using a 20-year period registration database of medical records in four Dutch general practices (a dynamic population based on the Continuous Morbidity Registration database).
  
  
  METHODS
  Medical history of the sample cohort was analysed for the diagnosis of a new episode of depressive disorder and descriptive statistics were used.
  
  
  RESULTS
  In total 982 patients were included, and 19 patients (1.9%) were diagnosed with a new depressive disorder in the last year of their life. The lifetime prevalence of depressive disorder in this sample was 8.2%.
  
  
  CONCLUSIONS
  The incidence of depressive disorder in the last phase of life is remarkably low in this study. These data were derived from actual patient care in general practice. Psychiatric diagnoses were made by GPs in the context of both patient needs and delivered care. A broader concept of depression in general practice is recommended to improve the diagnosis and treatment of mood disorders in patients in the last phase of life.
authors: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. f.warmenhoven@anes.umcn.nl
authors: Franca
authors: F
authors: Warmenhoven
authors: Hans
authors: H
authors: Bor
authors: Peter
authors: P
authors: Lucassen
authors: Kris
authors: K
authors: Vissers
authors: Chris
authors: C
authors: van Weel
authors: Judith
authors: J
authors: Prins
authors: Henk
authors: H
authors: Schers
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology*; D009426:Netherlands / Q000453:epidemiology; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011320:Primary Health Care; D011594:Psychometrics; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000523:psychology*; D019452:Terminally Ill / Q000523:psychology*
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