Twelve‐month course of depressive symptoms in older medical inpatients

McCusker, Jane; Cole, Martín G.; Ciampi, Antonio; Latimer, Éric; Windholz, Sylvia; Élie, Michel; Belzile, Éric

doi:10.1002/gps.1689

Cited by 16 publications

(16 citation statements)

References 26 publications

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“…We found that, similar to results in older medical inpatients (McCusker et al, 2007), there were three types of trajectories, characterized by their stability over time but differentiated by the level of symptom severity. Within each group of trajectories, the individual course may include fluctuations.…”

Section: Discussionsupporting

confidence: 76%

“…If the initial GDS is not considered in the analysis, then more severe pain and a history of depression, both associated with initial GDS, become significant predictors of a more severe trajectory. In a previous study among older medical inpatients, initial symptom level, female sex, and duration of depression were the main predictors of a more severe symptom trajectory (McCusker et al, 2007). Other research has also found that depressive symptoms are more severe during the first year after admission to an LTC facility (Hoover et al, 2010), suggesting that depressive symptoms be monitored more closely during this period.…”

Section: Discussionmentioning

confidence: 92%

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Six-month trajectories of self-reported depressive symptoms in long-term care

McCusker

Cole

Voyer

et al. 2015

Int. Psychogeriatr.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 92%

Six-month trajectories of self-reported depressive symptoms in long-term care

McCusker

Cole

Voyer

et al. 2015

Int. Psychogeriatr.

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“…A study among older medical inpatients indicated a fluctuant 1-year course for those with baseline MinD—4% maintained a stable diagnosis of MinD, 28% maintained stable ND recovery, and 68% vacillated between MDD, MinD, and ND (Cole et al, 2006). However, another investigation showed a relatively stable 1-year symptom course—measuring stability of depressive symptom severity (“minimal,” “mild,” or “moderate-severe” on the HAMD), rather than tracking categorical diagnoses (McCusker et al, 2007). Another study of inpatients with congestive heart failure reported more favorable rates of remission, 65% for MinD and 57% for MDD (statistically equivalent), but a trend for faster recovery time for MinD (3 weeks) versus MDD (20 weeks) (Koenig, 1998).…”

Section: Resultsmentioning

confidence: 99%

A tune in “a minor” can “b major”: A review of epidemiology, illness course, and public health implications of subthreshold depression in older adults

Meeks

Vahia

Lavretsky

et al. 2011

Journal of Affective Disorders

491

371

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BACKGROUND With emphasis on dimensional aspects of psychopathology in development of the upcoming DSM-V, we systematically review data on epidemiology, illness course, risk factors for, and consequences of late-life depressive syndromes not meeting DSM-IV-TR criteria for major depression or dysthymia. We termed these syndromes subthreshold depression, including minor depression and subsyndromal depression. METHODS We searched PubMed (1980–Jan 2010) using the terms: subsyndromal depression, subthreshold depression, and minor depression in combination with elderly, geriatric, older adult, and late-life. Data were extracted from 181 studies of late-life subthreshold depression. RESULTS In older adults subthreshold depression was generally at least 2–3 times more prevalent (median community point prevalence 9.8%) than major depression. Prevalence of subthreshold depression was lower in community settings versus primary care and highest in long-term care settings. Approximately 8–10% of older persons with subthreshold depression developed major depression per year. The course of late-life subthreshold depression was more favorable than that of late-life major depression, but far from benign, with a median remission rate to non-depressed status of only 27% after ≥1 year. Prominent risk factors included female gender, medical burden, disability, and low social support; consequences included increased disability, greater healthcare utilization, and increased suicidal ideation. LIMITATIONS Heterogeneity of the data, especially related to definitions of subthreshold depression limit our ability to conduct meta-analysis. CONCLUSIONS The high prevalence and associated adverse health outcomes of late-life subthreshold depression indicate the major public health significance of this condition and suggest a need for further research on its neurobiology and treatment. Such efforts could potentially lead to prevention of considerable morbidity for the growing number of older adults.

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“…These earlier studies often included assessments at fixed time points and more regular assessments than the design of the present study permitted. For example, McCusker et al [24] applied hierarchical clustering, a method different from ours, using 4 assessments (at inclusion and 3, 6, and 12 months after inclusion) with the Hamilton Rating Scale for Depression to group depressed medical inpatients into 3 trajectories according to severity (minimal, mild, and moderate/severe). The study by McCusker et al found that the course of depressive symptoms was largely stable within the 3 different trajectories.…”

Section: Trajectoriesmentioning

confidence: 99%

“…Previous studies have reported results from trajectory analyses in different settings for DLL [1,[13][14][15][24][25][26][27][28][29] . However, few such studies have included hospitalized older patients in specialist health care services for old age psychiatry.…”

Section: Introductionmentioning

confidence: 99%

Trajectories of Depression in Late Life: A 1-Year Follow-Up Study

Borza

Engedal²,

Bergh³

et al. 2017

Dement Geriatr Cogn Disord

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Aims: To investigate the prognosis of depression in late life (DLL) in terms of the course of depression over 1 year and assess clinical factors related to the prognosis. Methods: We performed an observational, multicenter, longitudinal study of 160 patients aged ≥60 years who were admitted to inward treatment of DLL. The patients were followed with 3 assessments: at inclusion (T₀), at discharge from the hospital (T₁), and after 1 year (T₂). Growth mixture modeling was applied to identify patient classes following distinct trajectories of the Montgomery-Åsberg Depression Rating Scale (MADRS) score. Two regression models were estimated to assess clinical factors for the trajectories and for a clinical assessment of the depression course between T₁ and T₂. Results: Two trajectory classes were identified: one with higher and one with lower MADRS scores. Not being in remission at T₁ and a longer hospital stay were associated with higher odds of being in the trajectory class with more severe depression. Early-onset depression (EOD) was associated with higher odds of being in a group with a poorer clinical course between T₁ and T₂. Conclusion: EOD and not being in remission at discharge were important negative prognostic factors for DLL.

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Twelve‐month course of depressive symptoms in older medical inpatients

Abstract: The 12-month course of depression symptoms in this medically ill older sample was generally stable. Patients who will experience a more severe course can be identified by non-psychiatric staff at admission to hospital.

Cited by 16 publications

References 26 publications

Six-month trajectories of self-reported depressive symptoms in long-term care

Six-month trajectories of self-reported depressive symptoms in long-term care

A tune in “a minor” can “b major”: A review of epidemiology, illness course, and public health implications of subthreshold depression in older adults

Trajectories of Depression in Late Life: A 1-Year Follow-Up Study

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