Abstract

CAMARA, Concepción de la et al. Depression in the elderly community: II. Outcome in a 4.5 years follow-up. Eur. J. Psychiat. [online]. 2008, vol.22, n.3, pp.141-150. ISSN 0213-6163.

Background and Objectives: In this study, we test to what extent negative outcomes of depression reported in different countries may be confirmed in a Southern European population. Methods: This is a follow-up (mean 4.5 years) of the elderly sample interviewed in the baseline of the Zaragoza Study (or ZARADEMP 0). The general methodology is described in the previous paper. The same two-phase procedure completed at baseline was also implemented at follow-up and the same standardized instruments were used. Cases of depression at follow-up were diagnosed with AGECAT criteria. Operational criteria were also used for definition of both "incident case of depression" and "chronic case of depression". Results: Six hundred and sixty three elderly (61.4%) were reassessed at follow-up, and 216 died in the follow-up period. A negative outcome of both, major and minor depression was observed. Taken together, the pessimistic outcome (death, chronicity or conversion to other psychiatric diagnosis) was observed in 70.5% of cases of depression, but only in 30.8% of "non-cases", the differences being statistically significant (Z = 6.7; p <0.001). Similarly, a high proportion of subcases of depression had a negative prognosis (48.5%), the differences with "non-cases" also being statistically significant (Z = 2.7; p <0.005). Incidence rate of depression was 14.4 (95% C.I.: 11.0-18.6) the rate being significantly higher in women when compared to men. Conclusions: This is the first report of a negative outcome of depression in a representative sample of the elderly in a Southern European city. Subcases of depression also had a negative outcome. The clinical significance in AGECAT cases of depression is emphasized.

Keywords : Depression; Elderly; Outcome; Epidemiology; Prognosis.

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