Depression in older medical inpatients: One-year course and outcome

Objectives. This 1-year follow-up survey of 214 medical inpatients aged 65 and older describes the outcome of major depressive episode (MDE), determines the incidence of new episodes and identifies factors associated with outcome and with new episodes of MDE. Method. Follow-up information was obtained from 160 patients, 69 men and 91 women. Results. Of the 48 cases of MDE who were interviewed, 44% improved. Underlying dysthymic disorder strongly influenced outcome: of 21 cases of MDE alone, 62% were improved at follow-up; of the 27 cases in which MDE was superimposed on dysthymic disorder initially, only 30% were improved. New episodes of MDE occurred in 21% of patients, and were associated with dysthymic disorder initially and with change of meaning of life. Conclusions. Among older medical inpatients, NIDE, particularly when superimposed upon dysthymic disorder, is a persistent condition. Randomized trials are necessary to identify efficacious treatments. ((C) 1997 by John Wiley & Sons, Ltd.)