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One-Month Stability of Depression Among Elderly Home-Care Patients

Received December 2, 2002; revised April 9, May 1, 2003; accepted May 2, 2003. From Weill Medical College of Cornell University, Department of Psychiatry, Weill Medical College of Cornell University, White Plains, NY (PJR, BSM, GJM, ELB, MLB) and Pfizer Pharmaceuticals, New York, NY (DK). Send correspondence to Patrick J. Raue, Ph.D., Department of Psychiatry, Westchester Division, Weill Medical College of Cornell University, 21 Bloomingdale Road, White Plains, NY 10605. e-mail: praue{at}med.cornell.edu
©2003 American Association for Geriatric Psychiatry

Objective: Studies in primary care settings have shown that depression is often chronic and associated with negative outcomes among patients with medical illness. The stability of depression among home care recipients has not been investigated. The authors examined the 1-month stability of major depression in a representative sample of elderly adults shortly after their admission to home care. Methods: A group of 539 subjects over age 65, newly admitted to home care for skilled nursing, were interviewed with the Structured Clinical Interview for DSM-IV (SCID-IV). Depression severity, medical comorbidity, pain, functional status, cognitive status, and recent life events were also assessed. Of 84 subjects who met criteria for major depression (MDD) at baseline, 74 were available for 1-month follow-up interview. Results: At 1-month follow-up, 31 subjects (42%) continued to meet MDD criteria; 20 (27%) achieved partial remission; and 23 (31%) were in full remission. Fewer instrumental activity limitations at baseline, experiencing "a great deal" of pain, and absence of a recent stressful life event were associated with full remission at 1-month follow-up. Conclusion: Nearly one-half of newly admitted elderly home care patients who meet criteria for MDD continue to meet full criteria 1 month later. Functional and psychosocial factors affect the short-term course.

Key Words: Home Care • Depression