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The Prognosis of Depression in Old Age

Published online by Cambridge University Press:  02 January 2018

P. W. Burvill*
Affiliation:
The University of Western Australia
W. D. Hall
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales
H. G. Stampfer
Affiliation:
The University of Western Australia
J. P. Emmerson
Affiliation:
Department of Psychiatry and Behavioural Science, The University of Western Australia
*
University Department of Psychiatry and Behavioural Science, Royal Perth Hospital, GPO Box X2213, Perth, Western Australia 6001

Abstract

The 12–month outcome of 103 elderly depressed patients treated by psychiatrists in Perth, Western Australia, was good in 32–47% of cases, depending upon the stringency of the outcome criteria used. A higher than expected mortality was found, especially in men. No clear association was found between 12–month outcome and a variety of clinical variables at index admission, including chronic physical illness, severity of depression, and severe life events during follow-up. As the statistical power of this and other studies is small, it would be unwise at present to draw definite conclusions about the role of possible risk factors in the prognosis of depressed elderly. Vigorous treatment of the depressive illness and adequate after-care are important.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Baldwin, B. (1988) Late life depression: undertreated? British Medical Journal, 269, 519.CrossRefGoogle Scholar
Baldwin, J. A. (1980) Schizophrenia and physical disease: a preliminary analysis of data from the Oxford Record Linkage Study. In The Biochemistry of Schizophrenia and Addiction (ed. G. Hemmings). Lancaster: MTP Press.Google Scholar
Baldwin, R. C. & Jolley, D. J. (1986) The prognosis of depression. British Journal of Psychiatry, 149, 574583.Google Scholar
Benbow, S. M. (1989) The role of electroconvulsive therapy in the treatment of depressive illness in old age. British Journal of Psychiatry, 155, 147152.Google Scholar
Blazer, D. (1980) The diagnosis of depression in the elderly. Journal of the American Geriatrics Society, 28, 5258.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. (1978) The Social Origins of Depression. London: Tavistock.Google Scholar
Brown, J. H. & Paraskevas, F. (1982) Cancer and depression: cancer presenting with depressive illness: an autoimmune disease? British Journal of Psychiatry, 141, 227232.Google Scholar
Burvill, P. W., Hall, W. D., Stampfer, H. G., et al (1989) A comparison of early-onset and late-onset depressive illness in the elderly. British Journal of Psychiatry, 155, 673679.Google Scholar
Burvill, P. W., Mowry, B. & Hall, W. D. (1990) Quantification of physical illness in psychiatric research in the elderly. International Journal of Geriatric Psychiatry, 5, 161170.CrossRefGoogle Scholar
Carney, M. W. P., Roth, M. & Garside, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659674.Google Scholar
Cohen, J. (1977) Statistical Power Analysis for the Behavioral Sciences (revised edn). New York: Academic Press.Google Scholar
Copeland, J. R. M. (1988) Physical ill-health, age and depression. In Depressive Illness: Prediction of Course and Outcome (eds T. Helgason & R. J. Daly). Berlin: Springer-Verlag.Google Scholar
Duke University Centre for the Study of Ageing and Human Development (1978) Multidimensional Functional Assessment: The OARS Methodology. Durham NC: Duke University.Google Scholar
Emmerson, J., Burvill, P. W., Finlay-Jones, R. A., et al (1989) Life events, life difficulties and confiding relationships in the depressed elderly. British Journal of Psychiatry, 155, 787792.CrossRefGoogle ScholarPubMed
Eysenck, H. J. & Edwards, S. (1964) The Eysenck Personality Questionnaire. Windsor: NFER/Nelson.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 5773.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 185198.Google Scholar
Godber, C., Rosenvinge, H., Wilkinson, D., et al (1987) Depression in old age: prognosis after ECT. International Journal of Geriatric Psychiatry, 2, 1924.CrossRefGoogle Scholar
Goldberg, D. P. (1972) The Detection of Psychiatric Illness by Questionnaire. Maudsley monograph no. 21. London: Oxford University Press.Google Scholar
Jacoby, R. J. (1981) Depression in the elderly. British Journal of Hospital Medicine, 25, 4047.Google ScholarPubMed
Jolley, D. & Arie, T. (1976) Psychiatric services for the elderly: how many beds? British Journal of Psychiatry, 129, 418423.Google Scholar
Kay, D. W. K. (1962) Outcome and cause of death in mental disorders of old age: a long-term follow-up of functional and organic psychoses. Acta Psychiatrica Scandinavica, 38, 249276.Google Scholar
Kay, D. W. K. & Bergmann, K. (1966) A follow-up of a random sample of elderly people seen at home. Journal of Psychosomatic Research, 13, 312.Google Scholar
Kiloh, L. G., Andrews, G. & Neilson, M. (1988) The long-term outcome of depressive illness. British Journal of Psychiatry, 153, 752757.Google Scholar
La Rue, A., Bank, L. & Javik, L., et al (1979) Health in old age: how do physicians’ ratings and self-ratings compare? Journal of Gerontology, 34, 687691.Google Scholar
Lee, A. S. & Murray, R. M. (1988) The long-term outcome of Maudsley depressives. British Journal of Psychiatry, 153, 741751.Google Scholar
Lonnqvist, J. & Koshenvuo, M. (1988) Comments: mortality in depressive disorders; a 3–year prospective follow-up study in Finland. In Depressive Illness: Prediction of Course and Outcome (eds T. Helgason & R. J. Daly). Berlin: Springer-Verlag.Google Scholar
Millard, P. H. (1983) Depression in old age. British Medical Journal, 287, 375376.CrossRefGoogle ScholarPubMed
Mossey, J. M. & Shapiro, E. (1982) Self-rated health: a predictor of mortality among the elderly. American Journal of Public Health, 72, 800808.Google Scholar
Murphy, E. (1983) The prognosis of depression in old age. British Journal of Psychiatry, 142, 111119.Google Scholar
Murphy, E., Smith, R., Lindsay, J., et al (1988) Increased mortality rates in late-life depression. British Journal of Psychiatry, 152, 347353.Google Scholar
Post, F. (1962) The Significance of Affective Symptoms in Old Age. Maudsley monograph no. 10. London: Oxford University Press.Google Scholar
Post, F. (1972) The management and nature of depressive illness in late life: a follow-through study. British Journal of Psychiatry, 121, 393404.Google Scholar
Post, F. (1978) The functional psychoses. In Studies in Geriatric Psychiatry (eds A. D. Isaacs & F. Post). Chichester: John Wiley.Google Scholar
Post, F. (1986) Course and outcome of depression in the elderly. In Affective Disorders in the Elderly (ed. E. Murphy). Edinburgh: Churchill Livingstone.Google Scholar
Rifkin, A. (1988) ECT versus tricyclic antidepressants in depression: a review of the evidence. Journal of Clinical Psychiatry, 49, 37.Google ScholarPubMed
Roth, M. & Kay, D. W. K. (1956) Affective disorder arising in the senium. II. Physical disability as an aetiological factor. Journal of Mental Science, 102, 141150.Google Scholar
Singer, E., Garfinkel, R. & Cohen, S. M., et al (1976) Mortality and mental health: evidence from the Midtown Manhattan restudy. Social Science and Medicine, 10, 517525.CrossRefGoogle ScholarPubMed
Stendstedt, A. (1959) Involutional melancholia. Acta Psychiatrica Scandinavica (suppl. 127).Google Scholar
Yesavage, J. A., Brink, T. L., Rose, T. L., et al (1983) Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 3749.Google Scholar
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