Jm. Lyness et al., The importance of subsyndromal depression in older primary care patients: Prevalence and associated functional disability, J AM GER SO, 47(6), 1999, pp. 647-652
Citations number
27
Categorie Soggetti
Public Health & Health Care Science","General & Internal Medicine
OBJECTIVE: Existing diagnostic categories for depression may not encompass
the majority of older people suffering clinically significant depressive sy
mptoms. We have described the prevalence of subsyndromal depressive symptom
s and tested the hypothesis that patients with subsyndromal depression have
greater functional disability and general medical burden than nondepressed
subjects but less than patients with diagnosable depressions.
METHODS: Subjects were 224 patients, aged 60 years and older, recruited fro
m private internal medicine offices or a family medicine clinic. Validated
measures of psychopathology, medical burden, and functional status were use
d. The subsyndromal depression group was defined by a score of more than 10
on the Hamilton Rating Scale for Depression and by the absence of major or
minor depressive disorder. Analyses included multiple regression technique
s to determine the presence of group differences adjusted for demographic c
ovariates.
RESULTS: Subsyndromal depression was common (estimated point prevalence of
9.9% compared with 6.5% for major depression, 5.2% for minor depression, an
d .9% for dysthymic disorder), associated with functional disability and me
dical comorbidity to a degree similar to major or minor depression, and oft
en treated with antidepressant medications.
CONCLUSIONS: Although depressive conditions are common and are associated w
ith considerable functional and medical morbidity in older primary care pat
ients, many patients with clinically significant depressive symptoms are no
t captured by criteria-based syndromic diagnostic categories. Future work s
hould include intervention studies of subsyndromally depressed older person
s as well as attention to the course and biopsychosocial concomitants of di
agnosable and subsyndromal depressions in this population.