Factors Predicting Chronicity of Depression in Elderly Primary Care Patients

Abstract

Aim: The aim was to identify the factors predicting and related to chronicity of depression among depressed Finnish elderly subjects. Material and Methods: The study consisted of 97 depressed (DSM-III criteria) elderly (60 years or older) Finns treated in primary health care. The occurrence of depression was assessed after treatment and follow-up periods of about 15 months and 5 years, and the persons were classified according to their recovery: (a) persons depressed in all the three examinations (the chronically depressed) (n = 47), and (b) persons depressed in the first examination, but nondepressed in both follow-up examinations (the recovered) (n = 50). Results: Diurnal variation of symptoms and poor self-appreciation at the baseline and the onset of a severe disease, the deterioration of one's health status, and the death of a family member during the follow-up emerged as independent predictors or associates of the chronic course of depression in the logistic regression model. Conclusions: Depressed elderly subjects who develop a physical disease or whose family member dies during the treatment of depression have a high risk for a chronic course. Intensive antidepressant and psychotherapeutic treatment and adequate physical treatment of these patients are proposed, in order to increase the probability of recovery from depression.