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Am J Psychiatry 1991; 148:174-178
Copyright © 1991 by American Psychiatric Association
Persistence and remission of depressive symptoms in late life
GJ Kennedy, HR Kelman and C Thomas
Department of Psychiatry, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.
OBJECTIVE: The relation of poor health to the onset of depression symptoms
in late life is well recognized, but little attention has been given to
characteristics that might predict persistence or remission of depressive
symptoms. In previous analyses the authors found that increasing disability
and declining health preceded the emergence of depressive symptoms in older
community residents and accounted for 70% of the variance explained by
discriminant analyses. The aim of the present analysis was to examine the
relevance of changes in health and disability to the persistence of
depressive symptoms. METHOD: A representative sample of 1,855 adults aged
65 or older were assessed with the Center for Epidemiologic Studies
Depression Scale at baseline. Twenty-four months later, 1,577 individuals
were available for a second assessment of depressive symptoms. The
characteristics of the 97 community residents whose depressive symptoms
persisted over 24 months were compared to those of the 114 whose symptoms
remitted. RESULTS: Changes in health, differences in age, sleep
disturbance, and added formal support services accounted for more than 30%
of the variance between the persistently depressed and remission groups.
Advanced age and worsening health were associated with persistent symptoms,
improved health with remission. CONCLUSIONS: Previous studies have
indicated that untoward changes in health and disability play a major role
in the onset of depressive symptoms. These findings show a substantial
contribution to chronicity as well.
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