|
| | |
|
Am J Psychiatry 1997; 154:1376-1383
Copyright © 1997 by American Psychiatric Association
Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes
HG Koenig, LK George, BL Peterson and CF Pieper
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.
OBJECTIVE: The purpose of this study was to examine and compare rates of
depression, correlates, and course of symptoms in medically ill
hospitalized elders through use of six diagnostic schemes (inclusive,
etiologic, exclusive-inclusive, exclusive-etiologic, substitutive-
inclusive, and substitutive-etiologic). METHOD: A consecutive series of 460
cognitively unimpaired patients aged 60 or over who were admitted to the
medical inpatient services of Duke Hospital underwent a structured
psychiatric evaluation administered by a psychiatrist. Patients with
depression were contacted by telephone at 12-week intervals after discharge
to assess weekly change in depressive symptoms (median follow-up time = 47
weeks). RESULTS: The prevalence of major depression varied from 10% to 21%
depending on diagnostic scheme; similarly, minor depression varied from 14%
to 25%. Diagnostic strategy made little difference in known psychological
and health characteristics of patients with depression (predictive
validity) or severity of depressive symptoms (convergent validity). The
diagnostic strategy that best distinguished a severe and persistent major
depression was the exclusive-etiologic approach; however, this strategy
missed 49% of patients with major depression identified by the inclusive
approach, almost 60% of whom continued to experience persistent symptoms of
depression many weeks after discharge. CONCLUSIONS: Diagnostic strategy
affects rates of major and minor depression, with about a twofold
difference between the extremes. There is little reason, however, to choose
one diagnostic scheme over another in all cases. Diagnostic strategy should
be chosen on the basis of the specific goals and purposes of the examiner.
While the exclusive- etiologic approach identifies the most severe and
persistent depressions, the inclusive approach is the most sensitive and
reliable approach and is an intermediate predictor of persistent
depression.
This article has been cited by other articles:
|
|
|
|
 
J. McCusker, E. Latimer, M. Cole, A. Ciampi, and M. Sewitch
Major depression among medically ill elders contributes to sustained poor mental health in their informal caregivers
Age Ageing,
July 1, 2007;
36(4):
400 - 406.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. D. Thombs, G. Magyar-Russell, E. B. Bass, K. J. Stewart, K. K. Tsilidis, D. E. Bush, J. A. Fauerbach, U. D. McCann, and R. C. Ziegelstein
Performance Characteristics of Depression Screening Instruments in Survivors of Acute Myocardial Infarction: Review of the Evidence
Psychosomatics,
June 1, 2007;
48(3):
185 - 194.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Augustin, J.-A. Sahel, F. Bandello, R. Dardennes, F. Maurel, C. Negrini, K. Hieke, G. Berdeaux, and the MICMAC Study Group
Anxiety and Depression Prevalence Rates in Age-Related Macular Degeneration
Invest. Ophthalmol. Vis. Sci.,
April 1, 2007;
48(4):
1498 - 1503.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. G. Cole, J. McCusker, C. Dufouil, A. Ciampi, and E. Belzile
Short-Term Stability of Diagnoses of Major and Minor Depression in Older Medical Inpatients
Psychosomatics,
February 1, 2007;
48(1):
38 - 45.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Lyness
End-of-Life Care: Issues Relevant to the Geriatric Psychiatrist
Focus,
January 1, 2007;
5(4):
459 - 471.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Weinert and W. Meller
Epidemiology of Depression and Antidepressant Therapy After Acute Respiratory Failure
Psychosomatics,
October 1, 2006;
47(5):
399 - 407.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. McCusker, M. Cole, A. Ciampi, E. Latimer, S. Windholz, and E. Belzile
Does Depression in Older Medical Inpatients Predict Mortality?
J. Gerontol. A Biol. Sci. Med. Sci.,
September 1, 2006;
61(9):
975 - 981.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. G. Koenig
Depression outcome in inpatients with congestive heart failure.
Arch Intern Med,
May 8, 2006;
166(9):
991 - 996.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. G. Cole, J. McCusker, M. Elie, N. Dendukuri, E. Latimer, and E. Belzile
Systematic detection and multidisciplinary care of depression in older medical inpatients: a randomized trial
Can. Med. Assoc. J.,
January 3, 2006;
174(1):
38 - 44.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. E. Joynt and C. M. O'Connor
Lessons From SADHART, ENRICHD, and Other Trials
Psychosom Med,
May 1, 2005;
67(Supplement_1):
S63 - S66.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Lyness
End-of-Life Care: Issues Relevant to the Geriatric Psychiatrist
Focus,
April 1, 2005;
3(2):
341 - 353.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Ben-Noun
Mental Disorder that Afflicted King David the Great
History of Psychiatry,
December 1, 2004;
15(4):
467 - 476.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. Baldwin and R. Wild
Management of depression in later life
Adv. Psychiatr. Treat.,
March 1, 2004;
10(2):
131 - 139.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Akechi, T. Nakano, N. Akizuki, M. Okamura, K. Sakuma, T. Nakanishi, E. Yoshikawa, and Y. Uchitomi
Somatic Symptoms for Diagnosing Major Depression in Cancer Patients
Psychosomatics,
June 1, 2003;
44(3):
244 - 248.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. D. Sullivan, A. Z. LaCroix, J. A. Spertus, J. Hecht, and J. Russo
Depression Predicts Revascularization Procedures for 5 Years After Coronary Angiography
Psychosom Med,
March 1, 2003;
65(2):
229 - 236.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. L. Brown, G. McAvay, P. J. Raue, S. Moses, and M. L. Bruce
Recognition of Depression Among Elderly Recipients of Home Care Services
Psychiatr Serv,
February 1, 2003;
54(2):
208 - 213.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Uchitomi, I. Mikami, K. Nagai, Y. Nishiwaki, T. Akechi, and H. Okamura
Depression and Psychological Distress in Patients During the Year After Curative Resection of Non-Small-Cell Lung Cancer
J. Clin. Oncol.,
January 1, 2003;
21(1):
69 - 77.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Oxman, A. J. Dietrich, J. W. Williams Jr., and K. Kroenke
A Three-Component Model for Reengineering Systems for the Treatment of Depression in Primary Care
Psychosomatics,
December 1, 2002;
43(6):
441 - 450.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Green, W. M. McDonald, J. L. Vitek, M. Haber, H. Barnhart, R. A.E. Bakay, M. Evatt, A. Freeman, N. Wahlay, S. Triche, et al.
Neuropsychological and psychiatric sequelae of pallidotomy for PD: Clinical trial findings
Neurology,
March 26, 2002;
58(6):
858 - 865.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. W. Williams Jr, P. H. Noel, J. A. Cordes, G. Ramirez, and M. Pignone
Is This Patient Clinically Depressed?
JAMA,
March 6, 2002;
287(9):
1160 - 1170.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Seidlitz, J. M. Lyness, Y. Conwell, P. R. Duberstein, and C. Cox
Profile of Discrete Emotions in Affective Disorders in Older Primary Care Patients
Gerontologist,
October 1, 2001;
41(5):
643 - 651.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. Anderson, K. E. Freedland, R. E. Clouse, and P. J. Lustman
The Prevalence of Comorbid Depression in Adults With Diabetes: A meta-analysis
Diabetes Care,
June 1, 2001;
24(6):
1069 - 1078.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M. G. Cole, L. M. Elie, J. McCusker, F. Bellavance, and A. Mansour
Feasibility and Effectiveness of Treatments for Post-Stroke Depression in Elderly Inpatients: Systematic Review
J Geriatr Psychiatry Neurol,
March 1, 2001;
14(1):
37 - 41.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. R. Weinert
Epidemiology of Psychiatric Medication Use in Patients Recovering From Critical Illness at a Long-term Acute-Care Facility
Chest,
February 1, 2001;
119(2):
547 - 553.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. J. Klausner and G. S. Alexopoulos
The Future of Psychosocial Treatments for Elderly Patients
Psychiatr Serv,
September 1, 1999;
50(9):
1198 - 1204.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. J.G. Hoogendijk, I.E. C. Sommer, G. Tissingh, D. J.H. Deeg, and E.Ch. Wolters
Depression in Parkinson's Disease: The Impact of Symptom Overlap on Prevalence
Psychosomatics,
October 1, 1998;
39(5):
416 - 421.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
H. G. Koenig and M. Kuchibhatla
Use of Health Services by Hospitalized Medically Ill Depressed Elderly Patients
Am J Psychiatry,
July 1, 1998;
155(7):
871 - 877.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
R. C Baldwin
Review: few elderly inpatients who are depressed improve
Evid. Based Ment. Health,
May 1, 1998;
1(2):
61 - 61.
[Full Text]
|
|
|
|
|
|
|
H. G. Koenig, L. K. George, and B. L. Peterson
Religiosity and Remission of Depression in Medically Ill Older Patients
Am J Psychiatry,
April 1, 1998;
155(4):
536 - 542.
[Abstract]
[Full Text]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 1997
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
