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Depression in older adults with schizophrenia spectrum disorders: prevalence and associated factors.
Am J Geriatr Psychiatry. 2007 Dec; 15(12):991-8.AJ

Abstract

RATIONALE

Although depression is common in older adults with schizophrenia, it has not been well studied. The authors examine those factors that are related to depression in a multiracial urban sample of older persons with schizophrenia.

METHODS

The schizophrenia group consisted of 198 persons aged 55 or older who lived in the community and developed schizophrenia before age 45. Persons with substantial cognitive impairment were excluded from the study. A community comparison group (N = 113) was recruited using randomly selected census tract data. The authors adapted George's Social Antecedent Model of Depression, which consists of six categories comprising 16 independent variables, and used a dichotomous dependent variable based on a Center for Epidemiologic Studies Depression Scale cutoff score of > or = 16.

RESULTS

The schizophrenia group had significantly more persons with clinical depression than the community comparison group (32% versus 11%, respectively; chi(2) = 28.23, df = 1, p = 0.001). Bivariate analysis revealed that eight of the 16 variables were significantly related to clinical depression in the schizophrenia group. In logistic regression, six variables retained significance: physical illness (odds ratio [OR] = 1.60, 95% confidence interval [CI], 1.17-2.18), quality of life (OR = 0.84, 95% CI, 0.76-0.93), presence of positive symptoms (OR = 1.12, 95% CI, 1.02-1.21), proportion of confidants (OR = 0.03, 95% CI, 0.01-0.39), copes by using medications (OR = 2.12, 95% CI, 1.08-4.13), and copes with conflicts by keeping calm (OR = 1.34, 95% CI, 1.03-1.74).

CONCLUSION

Consistent with earlier studies of schizophrenia in older persons, the authors found physical health, positive symptoms, and several nonclinical variables to be associated with depression. Potential points for intervention include strengthening social supports, improving physical well-being, more aggressive treatment of positive symptoms, and increasing the recognition and treatment of depression.

Authors+Show Affiliations

SUNY Downstate Medical Center, Brooklyn, New York 11203, USA. shilpadiwan@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18056817

Citation

Diwan, Shilpa, et al. "Depression in Older Adults With Schizophrenia Spectrum Disorders: Prevalence and Associated Factors." The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, vol. 15, no. 12, 2007, pp. 991-8.
Diwan S, Cohen CI, Bankole AO, et al. Depression in older adults with schizophrenia spectrum disorders: prevalence and associated factors. Am J Geriatr Psychiatry. 2007;15(12):991-8.
Diwan, S., Cohen, C. I., Bankole, A. O., Vahia, I., Kehn, M., & Ramirez, P. M. (2007). Depression in older adults with schizophrenia spectrum disorders: prevalence and associated factors. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 15(12), 991-8.
Diwan S, et al. Depression in Older Adults With Schizophrenia Spectrum Disorders: Prevalence and Associated Factors. Am J Geriatr Psychiatry. 2007;15(12):991-8. PubMed PMID: 18056817.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depression in older adults with schizophrenia spectrum disorders: prevalence and associated factors. AU - Diwan,Shilpa, AU - Cohen,Carl I, AU - Bankole,Azziza O, AU - Vahia,Ipsit, AU - Kehn,Michelle, AU - Ramirez,Paul M, PY - 2007/12/7/pubmed PY - 2008/1/26/medline PY - 2007/12/7/entrez SP - 991 EP - 8 JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry JO - Am J Geriatr Psychiatry VL - 15 IS - 12 N2 - RATIONALE: Although depression is common in older adults with schizophrenia, it has not been well studied. The authors examine those factors that are related to depression in a multiracial urban sample of older persons with schizophrenia. METHODS: The schizophrenia group consisted of 198 persons aged 55 or older who lived in the community and developed schizophrenia before age 45. Persons with substantial cognitive impairment were excluded from the study. A community comparison group (N = 113) was recruited using randomly selected census tract data. The authors adapted George's Social Antecedent Model of Depression, which consists of six categories comprising 16 independent variables, and used a dichotomous dependent variable based on a Center for Epidemiologic Studies Depression Scale cutoff score of > or = 16. RESULTS: The schizophrenia group had significantly more persons with clinical depression than the community comparison group (32% versus 11%, respectively; chi(2) = 28.23, df = 1, p = 0.001). Bivariate analysis revealed that eight of the 16 variables were significantly related to clinical depression in the schizophrenia group. In logistic regression, six variables retained significance: physical illness (odds ratio [OR] = 1.60, 95% confidence interval [CI], 1.17-2.18), quality of life (OR = 0.84, 95% CI, 0.76-0.93), presence of positive symptoms (OR = 1.12, 95% CI, 1.02-1.21), proportion of confidants (OR = 0.03, 95% CI, 0.01-0.39), copes by using medications (OR = 2.12, 95% CI, 1.08-4.13), and copes with conflicts by keeping calm (OR = 1.34, 95% CI, 1.03-1.74). CONCLUSION: Consistent with earlier studies of schizophrenia in older persons, the authors found physical health, positive symptoms, and several nonclinical variables to be associated with depression. Potential points for intervention include strengthening social supports, improving physical well-being, more aggressive treatment of positive symptoms, and increasing the recognition and treatment of depression. SN - 1064-7481 UR - https://www.unboundmedicine.com/medline/citation/18056817/Depression_in_older_adults_with_schizophrenia_spectrum_disorders:_prevalence_and_associated_factors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/15/12/991 DB - PRIME DP - Unbound Medicine ER -