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A prospective study of outcome and predictors of subclinical and clinical depression in an older biracial sample of psychiatric outpatients.
J Affect Disord. 2010 Mar; 121(3):204-11.JA

Abstract

OBJECTIVES

There continues to be a debate about the long-term prognosis of psychiatric treatment of depression in later life. There have been no long-term naturalistic studies of psychiatric outpatient treatment of older adults in the United States. This study examines outcome and predictors of various levels of depression among a biracial sample of geropsychiatric outpatients in Brooklyn, NY.

METHODS

We conducted a naturalistic study (median: 33 months) of 143 persons aged 55 and over with diagnoses of depression drawn from 15 psychiatry outpatient clinics and 2 geriatric day programs. Their mean age was 68 years, 87% were female, and 43% were white and 57% were black, among whom 37% were African Caribbeans. Using George's Social Antecedent Model of Depression, we examined the impact of 15 predictor variables on two outcome measures: presence of any either subclinical or clinical depression (CES-D score > or = 8) and presence of clinical depression (CES-D score > or = 16).

RESULTS

On follow-up, 84% and 90% of subclinically and clinically depressed persons at baseline, respectively, were depressed (CES-D > or = 8); 62% of those in remission at baseline were depressed. In logistic regression, 3 variables were significant predictors of any level of depression on follow-up: baseline depression, baseline anxiety, greater increase in anxiety symptoms during the follow-up period. These 3 variables along with financial strain were significant predictors of clinical depression on follow-up. There were no inter- or intra-racial differences in outcome.

CONCLUSIONS

The bleak outcome findings among older psychiatric outpatients in Brooklyn were consistent with unfavorable results reported in European studies. Because there were only a few predictors of outcome, strategies that target high risk persons - e.g., such as those with subclinical depression, anxiety, or in more economic distress - may prevent transition to severe and persistent depressive states.

Authors+Show Affiliations

SUNY Downstate Medical Center, Brooklyn, NY 11203, United States. carl.cohen@downstate.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19656576

Citation

Cohen, Carl I., et al. "A Prospective Study of Outcome and Predictors of Subclinical and Clinical Depression in an Older Biracial Sample of Psychiatric Outpatients." Journal of Affective Disorders, vol. 121, no. 3, 2010, pp. 204-11.
Cohen CI, Goh KH, Gustave M. A prospective study of outcome and predictors of subclinical and clinical depression in an older biracial sample of psychiatric outpatients. J Affect Disord. 2010;121(3):204-11.
Cohen, C. I., Goh, K. H., & Gustave, M. (2010). A prospective study of outcome and predictors of subclinical and clinical depression in an older biracial sample of psychiatric outpatients. Journal of Affective Disorders, 121(3), 204-11. https://doi.org/10.1016/j.jad.2009.05.021
Cohen CI, Goh KH, Gustave M. A Prospective Study of Outcome and Predictors of Subclinical and Clinical Depression in an Older Biracial Sample of Psychiatric Outpatients. J Affect Disord. 2010;121(3):204-11. PubMed PMID: 19656576.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of outcome and predictors of subclinical and clinical depression in an older biracial sample of psychiatric outpatients. AU - Cohen,Carl I, AU - Goh,Kah Hong, AU - Gustave,Mario, Y1 - 2009/08/04/ PY - 2009/02/23/received PY - 2009/05/05/revised PY - 2009/05/21/accepted PY - 2009/8/7/entrez PY - 2009/8/7/pubmed PY - 2010/4/15/medline SP - 204 EP - 11 JF - Journal of affective disorders JO - J Affect Disord VL - 121 IS - 3 N2 - OBJECTIVES: There continues to be a debate about the long-term prognosis of psychiatric treatment of depression in later life. There have been no long-term naturalistic studies of psychiatric outpatient treatment of older adults in the United States. This study examines outcome and predictors of various levels of depression among a biracial sample of geropsychiatric outpatients in Brooklyn, NY. METHODS: We conducted a naturalistic study (median: 33 months) of 143 persons aged 55 and over with diagnoses of depression drawn from 15 psychiatry outpatient clinics and 2 geriatric day programs. Their mean age was 68 years, 87% were female, and 43% were white and 57% were black, among whom 37% were African Caribbeans. Using George's Social Antecedent Model of Depression, we examined the impact of 15 predictor variables on two outcome measures: presence of any either subclinical or clinical depression (CES-D score > or = 8) and presence of clinical depression (CES-D score > or = 16). RESULTS: On follow-up, 84% and 90% of subclinically and clinically depressed persons at baseline, respectively, were depressed (CES-D > or = 8); 62% of those in remission at baseline were depressed. In logistic regression, 3 variables were significant predictors of any level of depression on follow-up: baseline depression, baseline anxiety, greater increase in anxiety symptoms during the follow-up period. These 3 variables along with financial strain were significant predictors of clinical depression on follow-up. There were no inter- or intra-racial differences in outcome. CONCLUSIONS: The bleak outcome findings among older psychiatric outpatients in Brooklyn were consistent with unfavorable results reported in European studies. Because there were only a few predictors of outcome, strategies that target high risk persons - e.g., such as those with subclinical depression, anxiety, or in more economic distress - may prevent transition to severe and persistent depressive states. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/19656576/A_prospective_study_of_outcome_and_predictors_of_subclinical_and_clinical_depression_in_an_older_biracial_sample_of_psychiatric_outpatients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(09)00231-6 DB - PRIME DP - Unbound Medicine ER -