Major Depression and Physical Illiness: Special Considerations in Diagnosis and Biologic Treatment

Cohen-Cole, Steven A.; Stoudemire, Alan

doi:10.1016/s0193-953x(18)30573-2

Cited by 147 publications

(60 citation statements)

References 56 publications

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“…Some clinicians interpret this to mean that the symptom is not a psychological reaction to the physical condition; others take it to mean that the symptom is not a consequence of the physical condition (e.g., insomnia due to coughing or shortness of breath at night); still others interpret this to mean that the symptom is not due to an organic mood syndrome, i.e., a direct physiological effect of an illness such as hypothyroidism (which is the exclusion criterion B-1 in DSM-III-R and criterion D in DSM-IV). As expected, the reliability of this method is poor given the lack of a standard for making these judgments (2).…”

mentioning

confidence: 78%

Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes

1997

AJP

279

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mentioning

confidence: 78%

Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes

1997

AJP

279

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“…Accuracy of depression diagnosis is particularly difficult in older persons. Depression and other forms of psychopathology may be underestimated in the elderly because many older adults minimize reports of sadness, anhedonia, and other psychological symptoms of depression secondary to physical health conditions [50][51][52][53][54][55]. Similarly, cognitive impairment in some older adults leads to under-reporting of depression [53].…”

Section: Discussionmentioning

confidence: 99%

Depression, Cardiovascular Disease, Diabetes, and Two-Year Mortality Among Older, Primary-Care Patients

Gallo

Bogner

Morales

et al. 2005

American Journal of Geriatric Psychiatry

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Objective-Depression is a major contributor to death and disability, but few follow-up studies of depression have been carried out in the primary care setting. We sought to assess whether depression in older patients is associated with increased mortality after a 2-year follow-up interval and to estimate the population attributable fraction (PAF) of depression on mortality in older primary care patients.Method-Longitudinal cohort analysis carried out in 20 primary care practices. Participants were identified though a two-stage, age-stratified (60-74; 75+) depression screening of randomly sampled patients; enrollment included patients who screened positive and a random sample of screened negative patients. In all, 1226 persons were assessed at baseline. Vital status at 2 years was the outcome of interest.Results-Of 1226 persons in the sample, 598 were classified as depressed. After 2 years, 64 persons had died. Persons with depression at baseline were more likely to die at the end of the 2-year followup interval than were persons without depression (relative odds 1.81, 95% confidence interval [1.07, 3.05]; Wald χ 2 = 4.96, df = 1, p = 0.03), even after accounting for potentially influential covariates such as whether the participant reported a history of myocardial infarction (MI) or diabetes. We estimated the PAF due to depression on mortality to be 13%. By comparison, the PAF on mortality due to baseline report of MI was 11%; diabetes 9%; and any cardiovascular disease 18%.Conclusions-Among older primary care patients over the course of a 2-year follow-up interval, depression contributed as much to mortality as did MI or diabetes.

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“…The differential diagnosis of these somatic symptoms can be doubly difficult when a mood disturbance is not readily evident (i.e. the depression is masked) as may happen fairly often among the elderly with concomitant physical illness (Cohen-Cole and Stoudemire, 1987;Ouslander, 1982). Cavenaugh et al (1983) have demonstrated empirically the loss of diagnostic discrimination for depression that can affect certain symptoms such as decreased energy, when physical illness is superimposed; while symptoms such as indecisiveness may remain discriminating.…”

Section: Differentiation Of Depression and Disabilitymentioning

confidence: 99%

Depression and disability in the elderly: Reciprocal relations and changes with age

Gurland¹,

Wilder²,

Berkman³

1988

Int J Geriat Psychiatry

172

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Major Depression and Physical Illiness: Special Considerations in Diagnosis and Biologic Treatment

Cited by 147 publications

References 56 publications

Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes

Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes

Depression, Cardiovascular Disease, Diabetes, and Two-Year Mortality Among Older, Primary-Care Patients

Depression and disability in the elderly: Reciprocal relations and changes with age

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