Hostname: page-component-6bf8c574d5-rwnhh Total loading time: 0 Render date: 2025-03-01T19:55:16.194Z Has data issue: false hasContentIssue false
  • English
  • Français

Prognosis of Depression in the Elderly

A Comparison with Younger Patients

Published online by Cambridge University Press:  02 January 2018

Henry Brodaty ,
Lynne Harris ,
Karin Peters ,
Kay Wilhelm ,
Ian Hickie ,
Philip Boyce ,
Philip Mitchell ,
Gordon Parker  and
Kerrie Eyers
Henry Brodaty*
Affiliation:
Academic Department of Psychogeriatrics, University of New South Wales and Mood Disorders Unit, Prince Henry Hospital, Little Bay, 2036, Australia
Lynne Harris
Affiliation:
Department of Behavioural Sciences, University of Sydney, Australia
Karin Peters
Affiliation:
Academic Department of Psychogeriatrics, Prince Henry Hospital
Kay Wilhelm
Affiliation:
Mood Disorders Unit, Prince Henry Hospital, and School of Psychiatry, University of New South Wales
Ian Hickie
Affiliation:
School of Psychiatry, University of New South Wales and Mood Disorders Unit, Prince Henry Hospital
Philip Boyce
Affiliation:
Department of Psychiatry, Nepean Hospital, University of Sydney
Philip Mitchell
Affiliation:
School of Psychiatry, University of New South Wales and Mood Disorders Unit, Prince Henry Hospital
Gordon Parker
Affiliation:
University of New South Wales, and Mood Disorders Unit, Prince Henry Hospital
Kerrie Eyers
Affiliation:
Mood Disorders Unit, Prince Henry Hospital
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

The prognosis of depression in the elderly was investigated in a mixed-age sample of 242 consecutive referrals, with DSM-III defined unipolar major depressive episode, to a specialist unit for mood disorders. Subjects were followed up at about 1 and 3.8 years. There was no significant difference in outcome between younger (under 40 years), middle aged (40–59 years) and older (60 years or more) depressed patients. For the 61 elderly subjects with depression, prognosis improved with time, with 25% having a lasting recovery at the first and 41% at the second follow-up. Early onset, recurrence, and poor premorbid personality were associated with a worse prognosis. Three (5%) elderly depressives had committed suicide and seven (11%) had died from natural causes by the second follow-up. Despite some methodological limitations, our findings suggest a more optimistic outlook and the need for longer, more assertive treatment for elderly, depressed patients.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 163 , Issue 5 , November 1993 , pp. 589 - 596
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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

American Psychiatric Association (1980) Diagnostic and Statistical Manual for Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
Australian Bureau of Statistics (1989) Mortality Tabulations. Canberra, ACT: Australian Bureau of Statistics.Google Scholar
Baldwin, R. (1988) Late life depression - undertreated? British Medical Journal, 296, 519.CrossRefGoogle ScholarPubMed
Baldwin, R. & Jolley, D. (1986) The prognosis of depression in old age. British Journal of Psychiatry, 149, 574–583.CrossRefGoogle ScholarPubMed
Blazer, D. G. (1989) Affective disorders in late life. In Geriatric Psychiatry (eds Busse, E. W. & Blazer, D. G.), p. 373. Washington, DC: American Psychiatric Press.Google Scholar
Bowers, J., Jorm, A. F., Henderson, A. S., et al (1990) General practitioners' detection of depression and dementia. Medical Journal of Australia, 153, 192–196.CrossRefGoogle Scholar
Bowers, J., Jorm, A. F., Henderson, A. S., et al (1992) General practitioners' reported knowledge about depression and dementia in elderly patients. Australian and New Zealand Journal of Psychiatry, 26, 168–174.CrossRefGoogle ScholarPubMed
Brodaty, H., Andrews, G. & Austin, A. (1982) Psychiatric illness in general practice II: How is it managed? Australian Family Physician, 11, 682–686.Google Scholar
Brodaty, H., Boyce, P., Wilhelm, K., et al (1987) The establishment of a Mood Disorders Unit. Australian and New Zealand Journal of Psychiatry, 21, 375–381.CrossRefGoogle ScholarPubMed
Brodaty, H., Peters, K., Boyce, P., et al (1991) Age and depression. Journal of Affective Disorders, 23, 137–149.CrossRefGoogle ScholarPubMed
Brodaty, H., Harris, L., Wilhelm, K., et al (1993) Lessons from a mood disorders unit. Australian and New Zealand Journal of Psychiatry, 27, 254–263.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. (1978) Social Origins of Depression. London: Tavistock.Google ScholarPubMed
Burvill, P. W., Hall, W. D., Stampfer, H. G., et al (1991a) The prognosis of depression in old age. British Journal of Psychiatry, 158, 64–71.CrossRefGoogle ScholarPubMed
Burvill, P. W., Stampfer, H. G. & Hall, W. D. (1991b) Issues in the assessment of outcome in depressive illness in the elderly. International Journal of Geriatric Psychiatry, 6, 269–277.CrossRefGoogle Scholar
Butler, R. N. & Lewis, M. I. (1982) Aging and Mental Health (3rd edn). St Louis, MO: C. V. Mosby.Google Scholar
Cole, M. G. (1983) Age, age of onset and course of primary depressive illness in the elderly. Canadian Journal of Psychiatry, 28, 102–104.CrossRefGoogle ScholarPubMed
Cole, M. G. (1985) The course of elderly depressed outpatients. Canadian Journal of Psychiatry, 30, 217–220.CrossRefGoogle Scholar
Cole, M. G. (1990) The prognosis of depression in the elderly. Canadian Medical Association Journal, 143, 633–639.Google ScholarPubMed
Comfort, A. (1980) Practice of Geriatric Psychiatry. New York: Elsevier North Holland.Google Scholar
Congalton, A. A. (1969) Status ranking list of occupations in Australia. Appendix B to Status and Prestige in Australia. Melbourne: G. W. Cheshire.Google Scholar
Cox, D. R. (1972) Regression models and life tables. Journal of the Royal Statistical Society, Series B34, 34–202.Google Scholar
Department of Clinical Epidemiology and Biostatistics, Macmaster University Health Sciences Centre (1981) How to read clinical journals 3: to learn the clinical course and prognosis of disease. Canadian Medical Association Journal, 124, 869–872.Google Scholar
Eysenck, H. J. & Eysenck, S. B. E. (1964) The Manual of the Personality Inventory. London: University of London Press.Google Scholar
Frank, E., Prien, R. F., Jarrett, R. B., et al (1991) Conceptualization and rationale for consensus definition of terms in Major Depressive Disorder. Remission, recovery, relapse and recurrence. Archives of General Psychiatry, 48, 851–855.CrossRefGoogle ScholarPubMed
Gilchrist, P. N., Rozenbilds, U. Y., Martin, E., et al (1985) A study of 100 consecutive admissions to a psychogeriatric unit. Medical Journal of Australia, 143, 236–237.CrossRefGoogle ScholarPubMed
Godber, C., Rosenwinge, H., Wilkinson, D., et al (1987) Depression in old age: prognosis after ECT. International Journal of Geriatric Psychiatry, 2, 19–24.CrossRefGoogle Scholar
Goldberg, D. P. (1972) The Detection of Psychiatric Illness by Questionnaire. London: Oxford University Press.Google Scholar
Gurland, B. J. (1976) The comparative frequency of depression in various adult age groups. Journal of Gerontology, 31, 283–292.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.CrossRefGoogle ScholarPubMed
Jablensky, A. (1987) Prediction of the course and outcome of depression. Psychological Medicine, 17, 1–9.CrossRefGoogle ScholarPubMed
Jorm, A. F. (1990) The Epidemiology of Alzheimer's Disease and Related Disorders. London: Chapman & Hall.Google Scholar
Kay, D., Roth, M. & Hopkins, B. (1955) Affective disorders in the senium: their association with organic cerebral degeneration. Journal of Mental Science, 101, 302–316.CrossRefGoogle ScholarPubMed
Kiloh, L. G., Andrews, G. & Neilson, M. (1988) The long-term outcome of depressive illness. British Journal of Psychiatry, 153, 752–757.CrossRefGoogle ScholarPubMed
Lee, A. S. & Murray, R. M. (1988) The long-term outcome of Maudsley depressives. British Journal of Psychiatry, 153, 741–751.CrossRefGoogle ScholarPubMed
Lindesay, J., Briggs, K. & Murphy, E. (1989) The Guy's/Age Concern survey. Prevalence rates of cognitive impairment, depression and anxiety in an urban elderly community. British Journal of Psychiatry, 155, 317–329.CrossRefGoogle Scholar
Magni, G., Palazzolo, O. & Bianchin, G. (1988) The course of depression in elderly outpatients. Canadian Journal of Psychiatry, 33, 21–24.CrossRefGoogle ScholarPubMed
Mant, A., Eyland, E. A., Pond, D. S., et al (1988) Recognition of dementia in general practice. Comparison of general practitioners' opinions and the Blessed Dementia Rating Scale. Family Practice, 5, 184–188.CrossRefGoogle ScholarPubMed
Meats, P., Timol, M. & Jolley, D. (1991) Prognosis of depression in the elderly. British Journal of Psychiatry, 159, 549–663.CrossRefGoogle ScholarPubMed
Millard, P. (1983) Depression in old age. British Medical Journal, 267, 375–376.CrossRefGoogle Scholar
Murphy, E. (1983) The prognosis of depression in old age. British Journal of Psychiatry, 142, 111–119.CrossRefGoogle ScholarPubMed
Myers, J. K., Weissman, M. M., Tischler, G. L., et al (1984) Six-month prevalence of psychiatric disorders in three communities. Archives of General Psychiatry, 42, 959–969.CrossRefGoogle Scholar
Parker, G., Hadzi-Pavlovic, D., Boyce, P., et al (1990) Classifying depression by mental state signs. British Journal of Psychiatry, 157, 55–65.CrossRefGoogle ScholarPubMed
Parker, G., Hadzi-Pavlovic, D., Hickie, I., et al (1991) Psychotic depression: a review and clinical experience. Australian and New Zealand Journal of Psychiatry, 25, 169–180.CrossRefGoogle ScholarPubMed
Paulsen, A. S., Crowe, R. R., Noyes, R., et al (1988) Reliability of the telephone interview in diagnosing anxiety disorders. Archives of General Psychiatry, 45, 62–63.CrossRefGoogle ScholarPubMed
Post, F. (1962) The Significance of Affective Symptoms in Old Age (Maudsley monograph 10). London: Oxford University Press.Google Scholar
Post, F. (1972) The management and nature of depressive illnesses in late life: a follow-through study. British Journal of Psychiatry, 121, 393–404.CrossRefGoogle ScholarPubMed
Robinson, J. R. (1989) The natural history of mental disorders in old age. A long-term study. British Journal of Psychiatry, 154, 783–789.CrossRefGoogle ScholarPubMed
Siegel, S. (1956) Nonparametric Statistics for the Behavioral Sciences. New York: McGraw-Hill.Google Scholar
Snowdon, J. (1991) Bed requirements for an area psycho-geriatric service. Australian and New Zealand Journal of Psychiatry, 25, 56–62.CrossRefGoogle Scholar
Weissman, M. & Both well, S. (1976) Assessment of social adjustment by patient self-report. Archives of General Psychiatry, 33, 111–115.CrossRefGoogle ScholarPubMed
Welkowitz, J., Ewin, R. B. & Cohen, J. (1976) Introductory Statistics for the Behavioral Sciences. New York: Academic Press.Google Scholar
Willmuth, L. R. (1979) Medical views of depression in the elderly: historical notes. Journal of the American Geriatric Society, 27, 495–499.CrossRefGoogle ScholarPubMed
Zung, W. W. K. (1965) A self-rated depression scale. Archives of General Psychiatry, 12, 63–70.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.