Am J Psychiatry 1993; 150:728-733
Copyright © 1993 by American Psychiatric Association
Does age make a difference in the effects of physical health and social support on the outcome of a major depressive episode?
DC Hughes, D DeMallie and DG Blazer
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
OBJECTIVE: The authors examined the effects of physical health and social
support on 6-month outcome of a major depressive episode in 67 patients who
were less than 60 years old and 46 patients who were 60 years old or older.
They hypothesized that despite their higher rate of troublesome health
problems, older patients would have fewer depressive symptoms at follow-up
than would younger patients. METHOD: The Center for Epidemiologic Studies
Depression Scale (CES-D Scale) and a modified version of the National
Institute of Mental Health Diagnostic Interview Schedule were used to
gather data from inpatients and outpatients treated at Duke University
Medical Center during a face-to-face interview at baseline and over the
telephone at 6-month follow-up. At baseline, all patients met DSM-III-R
criteria for a major depressive episode. Data analyses included bivariate
and multivariate procedures. RESULTS: At baseline, the mean CES-D Scale
scores of the two age groups were similar. As expected, the mean illness
index score of the older patients was significantly higher and their mean
impaired subjective social support score was slightly lower than those of
the younger patients. At 6-month follow-up, the mean CES-D Scale score of
the younger patients was above the depressive threshold, but the mean CES-D
Scale score of the older patients was below the depressive threshold. The
illness index and impaired subjective support measures were significant
predictors of depressive symptoms at 6 months for the younger patients but
not for the older patients. CONCLUSIONS: The authors conclude that older
depressed patients have a more favorable prognosis than younger depressed
patients. Predictors of outcome vary by age.
