Regular Research ArticlesThe Clinical Significance of Subsyndromal Depression in Older Primary Care Patients
Section snippets
METHODS
The study methods have been described previously.15 In brief, we attempted to enroll all patients age 65 years or older who presented for care on selected days from primary care offices in internal medicine and family medicine, including private practice and hospital-based clinic settings. Potentially eligible subjects were asked for permission to approach them by telephone after their primary care appointment to ask about study participation; consenting patients were then called, in the order
RESULTS
Of 2,476 potentially eligible subjects appearing in the study practices on selected recruitment days, 1,322 were called for study enrollment; of these, 662 subjects (50.1%) were enrolled, a completion rate that is consistent with previous work using intensive, rigorous assessment methodologies such as the SCID in primary care settings.29 The enrolled subjects included 419 females (63.3%) and comprised 613 (92.6%) whites, 32 (4.8%) blacks, and 17 (2.6%) from other racial or ethnic groups.
CONCLUSIONS
The primary study hypothesis was partly confirmed. The variously defined subsyndromal depression groups had a greater proportion of females than the nondepressed group, similar to the major and minor depression groups. Compared with the nondepressed group, the SSD groups had greater overall depressive symptom severity, unsurprisingly given the group definitions. Importantly, the SSD groups also had greater functional disability, the latter particularly evident with the GAF rating of psychiatric
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This work was supported by grants NIMH R01 MH61429 and K24 MH71509.
This work was presented in part at the International College of Geriatric Psychoneuropharmacology, Basel, Switzerland, October 16, 2004.
The authors thank the patients, staff, and providers of the following primary care practices: University of Rochester Medical Center, Department of Medicine; Pulsifer Medical; East Ridge Family Medicine; Highland Family Medicine; Olsan Medical; Clinton Crossings Medical; Panorama Internal Medicine; Highland Geriatric Medicine; and Culver Medical. The authors also thank the following for technical assistance: Karen Gibson, M.S.Ed.; Constance Bowen, M.A.; James Evinger, M.Div.; Cameron Gardner, M.D.; Michael New; Andra Niculescu, M.D.; Jean Sauvain, B.S.; Jill Scheltz, B.A., L.M.T.; and Judy Woodhams, M.F.A.