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Am J Psychiatry 1992; 149:1575-1579
Copyright © 1992 by American Psychiatric Association
Recovery and relapse from major depressive disorder in the elderly
GA Hinrichsen
Geropsychiatry Service, Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY 11004.
OBJECTIVE: Results from the National Institute of Mental Health (NIMH)
Collaborative Study of the Psychobiology of Depression raised serious
concerns about the longer-term prognosis for major depressive disorder in
younger persons. However, little research has examined the prognosis for
major depressive disorder in the elderly despite suggestions that they have
poorer clinical outcomes than younger adults. The objective of this study
was to 1) document rates of recovery and relapse from major depressive
disorder in a large group of inpatient elderly and 2) compare recovery and
relapse rates from major depressive disorder in the elderly with those in a
mixed-age patient group from the NIMH collaborative study. METHOD: The
psychiatric status of 127 elderly inpatients diagnosed with major
depressive disorder by Research Diagnostic Criteria was evaluated for 1
year. The same diagnostic and follow-up method to assess psychiatric
symptoms employed in the NIMH study were used. RESULTS: One year after
study admission, 72% of elderly patients had recovered. Nineteen percent of
recovered patients, however, had a subsequent episode of major depressive
disorder. Recovery and relapse rates in the elderly did not significantly
differ from those reported for the mixed-age group in the NIMH study.
CONCLUSIONS: It is erroneous to single out the elderly as being more likely
to have poorer longitudinal treatment outcomes than others. Study findings
indicate the need for continued refinement of somatic and nonsomatic
treatments for the elderly to improve rates of sustained recovery from
depression.
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