SUMMARYA cohort of 104 patients newly admitted to a medical long-term care facility was studied over 1 year for evolution of depression. Seven variables that were associated with level of depression were used 'in discriminant function analyses. Results showed that the variables had about 90% accuracy in predicting depressed versus non-depressed groups with good sensitivity and specificity. The variables measured: coping with admission; life satisfaction at admission; affective and non-affective symptoms at admission; clinical health status after admission; friends in hospital after admission; and changes in affective symptoms after admission before the onset of depression.KEY woms-Depression, nursing homes, long-term care, coping, life satisfaction, health status, social supports.In a recent article in this Journal (Foster el al., 1991) we reported confirmation of a study (Katz et al., 1989) showing that the incidence rate of clinical depression in medical long-term care facilities (LTCF) is quite high and approximately 14%. This rate may be fairly uniform across both geriatric and younger patients, across gender, across different types of LTCFs (nursing facility; rehabilitation and chronic care medicine hospital), and across differing lengths of institutional stay. This incidence rate suggests there may be over 240 000 new cases of clinical depression occurring per year in the United States LTCF system. Several recent studies (Ashby et al., Katz et al., 1989;Parmelee et al., 1992;Rovner et al., 1991) have documented an excessive and high mortality rate associated with depression in LTCFs that is not related to suicide. The cause of the increased mortality rate is not clearly defined, with some studies indicating the depression is associated with poor physical health (Parmelee et al., 1992) while others show that poor physical health status is only one of multiple biopsychosocial factors related to