Outcome of depression in later life in primary care: longitudinal cohort study with three years’ follow-up
TLDR
Using readily available prognostic factors (for example, severity of the index episode, a family history of depression, and functional decline) could help direct treatment to those at highest risk of a poor prognosis.Abstract:
Objectives To study the duration of depression, recovery over time, and predictors of prognosis in an older cohort (≥55 years) in primary care.
Design Longitudinal cohort study, with three years’ follow-up.
Setting 32 general practices in West Friesland, the Netherlands.
Participants 234 patients aged 55 years or more with a prevalent major depressive disorder.
Main outcome measures Depression at baseline and every six months using structured diagnostic interviews (primary care evaluation of mental disorders according to diagnoses in Diagnostic and Statistical Manual of Mental Disorders, fourth edition) and a measure of severity of symptoms (Montgomery Asberg depression rating scale). The main outcome measures were time to recovery and the likelihood of recovery at different time points. Multivariable analyses were used to identify variables predicting prognosis.
Results The median duration of a major depressive episode was 18.0 months (95% confidence interval 12.8 to 23.1). 35% of depressed patients recovered within one year, 60% within two years, and 68% within three years. A poor outcome was associated with severity of depression at baseline, a family history of depression, and poorer physical functioning. During follow-up functional status remained limited in patients with chronic depression but not in those who had recovered.
Conclusion Depression among patients aged 55 years or more in primary care has a poor prognosis. Using readily available prognostic factors (for example, severity of the index episode, a family history of depression, and functional decline) could help direct treatment to those at highest risk of a poor prognosis.read more
Citations
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Journal ArticleDOI
Depression in older adults
TL;DR: This work considers recent systematic reviews, meta-analyses, and randomised controlled trials to consider identification and treatment of depression in older adults, especially as older patients may have different presentations and needs than younger ones.
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Minor and major depression and the risk of death in older persons
TL;DR: Even after adjustment for sociodemographics, health status, and health behaviors, minor depression in older men and major depression in both old men and women increase the risk of dying.
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Two-year course of depressive and anxiety disorders: Results from the Netherlands Study of Depression and Anxiety (NESDA)
Brenda W.J.H. Penninx,Brenda W.J.H. Penninx,Brenda W.J.H. Penninx,Willem A. Nolen,Femke Lamers,Frans G. Zitman,Johannes H. Smit,Philip Spinhoven,Pim Cuijpers,Peter J. de Jong,Harm W.J. van Marwijk,Klaas van der Meer,Peter F. M. Verhaak,Miranda Laurant,Ron de Graaf,Witte J.G. Hoogendijk,Nic J.A. van der Wee,Johan Ormel,Richard van Dyck,Aartjan T.F. Beekman +19 more
TL;DR: Their differential course trajectory justifies separate consideration of pure depression, pure anxiety and comorbid anxiety-depression in clinical practice and psychiatric nosology.
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Diagnostic validity and added value of the geriatric depression scale for depression in primary care: A meta-analysis of GDS30 and GDS15
TL;DR: It is estimated that the potential gain of the GDS(15) in primary care to be 8% over unassisted clinical detection but at a cost of 3-4 minutes of extra time per appointment, while the G DS(30) is recommended but not in the diagnosis of late-life depression inPrimary care.
Journal ArticleDOI
Six-month postintervention depression and disability outcomes of in-home telehealth problem-solving therapy for depressed, low-income homebound older adults.
Namkee G. Choi,C. Nathan Marti,Martha L. Bruce,Mark T. Hegel,M.S.W. Nancy L. Wilson M.A.,M.S.W. Nancy L. Wilson M.A.,Mark E. Kunik,Mark E. Kunik +7 more
TL;DR: Both depression and disability outcomes of telehealth problem‐solving therapy (tele‐PST via Skype video call) for low‐income homebound older adults over 6 months postintervention are reported.
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