Document Detail


Minor depression and physical outcome trajectories in heart failure and pulmonary disease.
MedLine Citation:
PMID:  16534439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We examined conjoint trajectories of depression-physical illness outcomes in elderly inpatients with minor depression and heart failure or pulmonary disease, and identified demographic, psychosocial, physical, and treatment predictors of trajectory. Consecutively admitted patients over age 50 with heart failure and/or chronic pulmonary disease were screened for minor depression using the Structured Clinical Interview for Depression. Follow-up evaluations were performed at 6 and 12 weeks using the Longitudinal Interview Follow-Up Evaluation, Hamilton Depression Scale, and Chronic Heart Failure-Chronic Respiratory Disease Questionnaire. Patients were placed into four depression-physical illness outcome trajectories: (T#1) depression better, illness better; (T#2) depression better, illness same; (T#3) depression same, illness better; and (T#4) depression same, illness same. Bivariate and multivariate predictors were examined. Minor depression was identified in 587 patients. Of these, 487 were evaluated at 6 weeks and 444 at 12 weeks. By 6 weeks, 39.4% of patients improved both on depression and physical illness (T#1), and 27.3% improved on neither (T#4). By 12 weeks, 49.6% had improved on both and 20.5% on neither. Race, admitting hospital, past psychiatric history, family psychiatric history, comorbid physical illnesses, and antidepressant drug treatment independently predicted outcome trajectory. Improvements in depression and physical illness track closely together in elderly inpatients with heart failure or pulmonary disease. Baseline patient characteristics predict which outcome trajectory they are likely to follow after hospital discharge, and may be useful in diagnosis and management.
Authors:
Harold G Koenig; Joan Vandermeer; Angie Chambers; Lesley Burr-Crutchfield; Jeffrey L Johnson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Journal of nervous and mental disease     Volume:  194     ISSN:  0022-3018     ISO Abbreviation:  J. Nerv. Ment. Dis.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-14     Completed Date:  2006-04-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375402     Medline TA:  J Nerv Ment Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-17     Citation Subset:  AIM; IM    
Affiliation:
Department of Psychiatry, Duke University Medical Center, Durham, North Carolina 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antidepressive Agents / therapeutic use
Chronic Disease
Comorbidity
Continental Population Groups
Depressive Disorder / diagnosis*,  epidemiology,  psychology
Female
Follow-Up Studies
Health Status
Heart Failure / diagnosis,  epidemiology*,  psychology
Hospital Distribution Systems
Hospitalization
Hospitals, Community
Humans
Lung Diseases / diagnosis,  epidemiology*,  psychology
Male
Outcome Assessment (Health Care)
Patient Discharge
Prognosis
Psychiatric Status Rating Scales / statistics & numerical data
Questionnaires
Severity of Illness Index
Sickness Impact Profile
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01-MH57662/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Antidepressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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