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Twelve‐month course of depressive symptoms in older medical inpatients
Author(s) -
McCusker Jane,
Cole Martin,
Ciampi Antonio,
Latimer Eric,
Windholz Sylvia,
Elie Michel,
Belzile Eric
Publication year - 2007
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.1689
Subject(s) - depression (economics) , hamd , medicine , depressive symptoms , logistic regression , psychiatry , prospective cohort study , pediatrics , cognition , anxiety , economics , macroeconomics
Background The study aimed: (1) to describe the 12‐month course of depressive symptoms among medical inpatients aged 65 +, and (2) to investigate predictors of a more severe course that could be identified easily by non‐psychiatric staff. Methods Patients were recruited at two Montreal hospitals. Inclusion criteria were: aged 65 +, admitted to medical service, at most mild cognitive impairment. Patients were screened for major and minor depression (DSM‐IV criteria). All depressed patients and a random sample of non‐depressed patients were invited to participate in the prospective study. The Hamilton Depression Scale (HAMD) was administered at admission, 3, 6, and 12 months. Individual patient trajectories of depressive symptoms over time were grouped using hierarchical clustering into three patient groups with a minimal, mild, and moderate/severe course of symptoms, respectively. The baseline predictors of a more severe clinical course were identified using ordinal logistic regression. Results Two hundred and thirty‐two patients completed baseline and one or more follow‐up interviews. Baseline patient characteristics that independently predicted a more severe symptom course included higher initial HAMD score, depressive core symptoms lasting 6 months or more, and female sex. Conclusion The 12‐month course of depression symptoms in this medically ill older sample was generally stable. Patients who will experience a more severe course can be identified by non‐psychiatric staff at admission to hospital. Copyright © 2006 John Wiley & Sons, Ltd.