DEPRESSION IN OLDER PATIENTS IN RESIDENTIAL CARE - SIGNIFICANCE OF DYSPHORIA AND DIMENSIONAL ASSESSMENT

To investigate the significance of subsyndromal depressive states in g eriatric patients, the authors used data from ongoing studies of depre ssion in older patients in residential care to evaluate the clinical c orrelates of dysphoria. They find that dysphoria is, in general a pers istent state associated with increased medical illness, pain, self-car e deficits, and mortality relative to euthymic subjects; thus it is cl inically significant. Differences between dysphoria and major depressi on in the extent of associated disability and mortality, but not in me asures of medical illness pain, or persistence, remain significant aft er controlling for self-ratings of depression from the Geriatric Depre ssion Scale. This finding suggests that dimensional assessments can ac count for some of the correlates of depression, but that categorical d iagnoses are required for others.