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 crit eria for a major depression. Method: Patients ages sixty and older presenti ng at two ambulatory internal medicine centers were administered the CES-D. Among those scoring greater than or equal to 11, 104 completed a comprehen sive assessment of their psychiatric symptomatology, medical illness, and f unctional abilities. The assessment battery was again administered six mont hs later. Results: The point prevalence of major depression in older primar y care patients is estimated at 9 percent based on SCID interviews. Patient s meeting criteria for this diagnosis compared to those who are symptomatic but not experiencing a major depression described more extensive psychopat hology but also significantly more limitations in performing social and fun ctional roles. At six-month follow-up, only 11.5 percent of those initially diagnosed with a major depression were considered fully recovered. Conclus ions: Major depression is a prevalent disorder in older primary care patien ts which affects their ability to perform expected social and physical role s, Mechanisms for delivering efficacious treatments in routine medical prac tice are of a high priority.