Characteristics and course of major depression in older primary care patients

Objective: Identify the morbidity patterns displayed by older primary care patients experiencing depressive symptomatology who do and do not meet criteria for a major depression. Method: Patients ages sixty and older presenting at two ambulatory internal medicine centers were administered the CES-D. Among those scoring greater than or equal to 11, 104 completed a comprehensive assessment of their psychiatric symptomatology, medical illness, and functional abilities. The assessment battery was again administered six months later. Results: The point prevalence of major depression in older primary care patients is estimated at 9 percent based on SCID interviews. Patients meeting criteria for this diagnosis compared to those who are symptomatic but not experiencing a major depression described more extensive psychopathology but also significantly more limitations in performing social and functional roles. At six-month follow-up, only 11.5 percent of those initially diagnosed with a major depression were considered fully recovered. Conclusions: Major depression is a prevalent disorder in older primary care patients which affects their ability to perform expected social and physical roles, Mechanisms for delivering efficacious treatments in routine medical practice are of a high priority.