The prognosis of depressive disorder in elderly primary care patients. An exploratory observational study: Course at 6 and 12 months

Abstract

Objective - To assess the course of depression or borderline depression and its determinants in elderly primary care patients. Design - An observational cohort study with three measurements, at inclusion and after 6 and 12 months. Setting - 14 general practitioners (GPs) in the western region of the Netherlands. Patients - From a baseline random sample of 582 consecutive elderly patients 65 + years of age, a total of 39 patients with depression and 60 with borderline depression were available for this cohort study. Main outcome measures - Diagnostic assessment was carried out in the patients' homes by trained interviewers according to the Diagnostic Interview Schedule (plus additional questions to assess minor depression). Results - Of the 39 patients with depression at baseline, 20 had depression after 6 months, and 18 after 12 months. Of the 60 patients with borderline depression at baseline, 53 had no evidence of depression after 6 months, and 54 had no evidence after 12 months. However, 7 patients had depression at 6 months and 6 patients at 12 months. Two determinants were related to a depressed state at 6 or 12 months among the patients with borderline depression: recognition by the GP and living with a partner. Conclusion - The results suggest that once elderly patients suffer from depression, this condition remains present for a long time. The prognosis for borderline depression was better, although 20% became depressed at 6 and/or 12 months. Future studies should aim to identify this group of patients.