Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-27T21:17:22.508Z Has data issue: false hasContentIssue false
  • English
  • Français

The outcome of elderly patients presenting with depressive symptoms

Published online by Cambridge University Press:  13 June 2014

Heidi Lee  and
Brian A Lawlor
Brian A Lawlor
Affiliation:
Mental Health and Ageing Research Unit, St Patrick's Hospital, Dublin 8, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: To examine the treatment of and outcome for elderly patients presenting with depressive symptoms.

Method: 100 consecutive elderly patients presenting to an old age psychiatric service with depressed mood were studied, 51 met DSM-III-R criteria for major depression and 49 met criteria for a range of other diagnoses. Demographic details, psychiatric history and clinical examination including Hamilton Depression Rating Scale, Mini-Mental State Examination and Cumulative Illness Rating Scale scores were recorded at first presentation. Treatment of index episode was recorded and outcome assessed at time of follow up (mean of 19.1 ± 9.1 months later).

Results: 57% of the major depressives and 41% of the other diagnoses had a good outcome. Within the other diagnoses group 30% of the comorbid anxiety/depression patients and none of the patients with dysthymia or personality disorder had a good outcome. In the major depression group there was no clear association between outcome and any clinical or demographic measure. Within the other diagnoses group a good outcome was significantly associated with being younger, having had more psychiatric admissions and being less likely to require benzodiazepine treatment (p < 0.05). The two groups received similar treatment except that the other diagnoses group were more likely to have had psychotherapy and the major depressed patients to have had ECT (trend) than the major depressed group.

Conclusions: The outcome for patients with major depression is similar to that found in previous studies. Patients with depressive syndromes associated with dysthymia, personality disorder, or comorbid anxiety/depression respond poorly to conventional treatments of depression.

Type
Research Article
Information
Irish Journal of Psychological Medicine , Volume 14 , Issue 1 , March 1997 , pp. 8 - 12
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Murphy, E. The prognosis of depression in old age. Br J Psychiatry 1983; 142: 111–9.Google ScholarPubMed
2.Millard, PH. Depression in old age. BMJ 1983; 287: 375–6.CrossRefGoogle ScholarPubMed
3.Post, F. The management and nature of depressive illnesses in late life: a follow through study. Br J Psychiatry 1972; 121: 393–404.CrossRefGoogle ScholarPubMed
4.Baldwin, RC, Jolly, DJ. The prognosis of depression in old age. Br J Psychiatry 1986;149:574–83.CrossRefGoogle ScholarPubMed
5.Cole, MG. The prognosis of depression in the elderly. Can Med Assoc J 1990; 143: 633–9.Google ScholarPubMed
6.Burvill, PW, Hall, WD, Stampfer, HG, Emmerson, JP. The prognosis of depression in old age? Br J Psychiatry 1991; 158: 64–71.CrossRefGoogle ScholarPubMed
7.Old Age Depression Interest Group (OADIG). How long shotdd the elderly take antidepressants? A double-blind placebo-controlled study of continuation/prophylaxis therapy with dothiepin. Br J Psychiatry 1993; 162: 175–82.CrossRefGoogle Scholar
8.George, LK, Blazer, DG, Hughes, DC, Fowler, N. Social support and the outcome of major depression. Br J'Psychiatry 1989; 154: 478–85.CrossRefGoogle ScholarPubMed
9.Hinrichsen, GA, Hernandez, NA. Factors associated with recovery from and relapse into major depressive disorder in the elderly. Am J Psychiatry 1993; 150: 1820–5.Google ScholarPubMed
10.Wittchen, HU, Essau, CA, Krieg, JC. Anxiety disorders: similarities and differences of comorbidity in treated and untreated groups. Br J Psychiatry 1991; 159 (suppl 12): 23–33.CrossRefGoogle Scholar
11.Van Valkenburg, C, Akiskal, H, Puzantian, V, et al.Anxious depressions: clinical, family history, and naturalistic outcome – comparisons with panic and major depressive disorders. J Affect Disord 1984; 6: 67–82.CrossRefGoogle ScholarPubMed
12.Kivela, S-L, Pahkala, K, Laippala, P. A one year prognosis of dysthymic disorder and major depression in old age. Int J Geriatr Psychiatry 1991; 6: 81–7.CrossRefGoogle Scholar
13.Brodaty, H, Harris, L, Peters, K, et al.Prognosis of depression in the elderly, a comparison with younger patients. Br J Psychiatry 1993; 163: 589–96.CrossRefGoogle ScholarPubMed
14.Bielski, RJ, Friedel, RO. Predictors of tricyclic antidepressant response. Arch Gen Psychiatry 1976; 33:1479–89.CrossRefGoogle ScholarPubMed
15.Shawcross, CR, Tyrer, P. Influence of personality on response to monoamine oxidase inhibitors and tricyclic antidepressants. J Psychiatr Res 1985;19: 557–62.CrossRefGoogle ScholarPubMed
16.Scott, J, Eccleston, D, Boys, R. Can we predict the persistence of depression. Br J Psychiatry 1992; 161: 633–7.CrossRefGoogle ScholarPubMed
17.Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62.CrossRefGoogle ScholarPubMed
18.Folstein, MF, Folstein, SE, McHugh, PR. ’Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.CrossRefGoogle Scholar
19.Miller, MD, Paradis, CF, Houck, PR, et al.Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatr Res 1992; 41(3): 237–48.CrossRefGoogle ScholarPubMed
20.Rabins, PV, Harvis, K, Koven, S. High fatality rates of late-life depression associated with cardiovascular disease. J Affect Disord 1985; 9: 165–7.CrossRefGoogle ScholarPubMed
21.Copeland, JRM, Davidson, IA, Dewey, ME, et al.Alzheimer's disease, other dementias, depression, and pseudodementia: prevalence, incidence and three year outcome in Liverpool. Br J Psychiatry 1992; 161: 230–9.CrossRefGoogle ScholarPubMed
22.Baldwin, RC, Benbow, SM, Marriott, A, Tomenson, B. Depression in old age. A reconsideration of cerebral disease in relation to outcome. Br J Psychiatry 1993; 163: 82–90.CrossRefGoogle ScholarPubMed
23.Blazer, D, Burchett, B, Service, C, George, LK. The association of age and depression among the elderly: an epidemiologic exploration. J Gerontol 1991; 46(6): M210–5.CrossRefGoogle ScholarPubMed