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Depressive Disorder in Older Medical Inpatients on General Medicine and Cardiology Services at a University Teaching Hospital

Departments of Psychiatry and Medicine, Duke University Medical Center.

The authors examined the prevalence, characteristics, and correlates of depressive disorder among medical inpatients age 60 or over at a private teaching hospital. Seventy-six of 129patients admitted to the general medicine and cardiology services at Duke University Hospital were screened for depressive disorder using DSM-III-R criteria. Depressive disorders were diagnosed in 34.2% of patients: major depression in 13–2%, adjustment disorder in 11.8%, depression not otherwise specified in 5.3%, organic mood disorder in 1.3%, and uncomplicated bereavement in 2.6%. Of patients with major depression, all had symptoms of mild-to-moderate severity. The most common presenting symptoms were insomnia, psychomotor agitation, difficulty concentrating, and loss of energy. Depression was more prevalent among women, general medicine patients, staff (vs. private) patients, and those who were functionally disabled or had multiple serious medical conditions. When other patient characteristics were controlled, however, only health factors were independently associated with depression.