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Outcomes of Patients with Mild Depression after 1 Year FREE

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The summary below is from the full report titled “Outcomes of Minor and Subsyndromal Depression among Elderly Patients in Primary Care Settings.” It is in the 4 April 2006 issue of Annals of InternalMedicine (volume 144, pages 496-504). The authors are J.M. Lyness, M. Heo, C.J. Datto, T.R. Ten Have, I.R. Katz, R. Drayer, C.F. Reynolds III, G.S. Alexopoulos, and M.L. Bruce.

Ann Intern Med. 2006;144(7):I-28. doi:10.7326/0003-4819-144-7-200604040-00003
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What is the problem and what is known about it so far?

Depression causes sadness or loss of interest or enjoyment of life to a degree that interferes with daily activities. It is a medical condition, not a normal reaction to such life situations as the death of a loved one or the loss of a job. About 1 of every 5 people experiences depression at some time in his or her life, and it is common among patients who see primary care providers. Common symptoms are lack of energy, change in sleep or appetite, and prominent thoughts of worthlessness or guilt. Sometimes the condition goes away on its own, but many depressed people need treatment with counseling or medication to speed recovery. Often, people with depression do not realize that their feelings are caused a medical condition and do not seek medical care. Although depression is associated with poor health outcomes, the prognosis for people with symptoms of mild depression (which is sometimes called subsyndromal depression) have not been well described.

Why did the researchers do this particular study?

The researchers wanted to see what happened to people with minor or subsyndromal depression over time.

Who was studied?

The study included 441 patients who were in the control group of a study of suicide prevention. Because they were in the control group, they did not receive special care for depression.

How was the study done?

At the start of the study, each of the patients was tested for symptoms of depression. The researchers identified 114 patients with no depression, 205 with minor or subsyndromal depression, and 122 with major depression. They then followed patients for 1 year and repeated the testing.

What did the researchers find?

Compared with patients who were not depressed at the start of the study, patients who had minor or subsyndromal depression were 5 times more likely to have major depression after 1 year. At that time, depression scores were worst in the patients who started out with major depression, intermediate in patients who started with minor or subsyndromal depression, and best in patients who started with no depression. Patients who had had worse health and less social support were the most likely to develop worsening depression.

What were the limitations of the study?

This study included only 441 of the 622 patients who completed the first round of testing. It is possible that the patients who dropped out of the study had different outcomes from those that returned for the testing after 1 year.

What are the implications of the study?

Patients with minor or subsyndromal depression are at a higher risk for major depression than patients who have no depression symptoms.





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