Older individuals face challenges that the majority of younger people do not. Medical and physical problems often occur in later life. Adjusting to major life changes, including loss of independence, loss of mobility, financial shifts, and smaller social networks can all affect a person’s well-being. For those who have depression, these types of conditions can compound an already difficult situation. Depression by itself can be difficult to treat. For older clients, the additional stresses that come with advanced age can make depression more treatment resistant and can increase risk of recurrence. In fact, the majority of clients who experience remission of depression often continue to experience subclinical symptoms for a period of time. Therefore, it is imperative to determine if these symptoms can predict relapse in clients undergoing treatment for depression, especially older individuals.
Dimitris N. Kiosses of the Department of Psychiatry at the Weill Cornell Institute of Geriatric Psychiatry at Cornell University in New York examined whether the duration of subclinical symptoms of depression could predict relapse in a sample of clients over the age of 60. All of the participants had received treatment for depression and were evaluated for two and a half years post-treatment. Kiosses found that nearly one fifth of the clients relapsed after treatment and nearly half of those who did not relapse experienced subclinical symptoms in the first six months following treatment. When he looked further, Kiosses found that the duration of these symptoms directly predicted risk of relapse. In other words, the longer the client had symptoms during the first six months after treatment and remission, the higher the risk of relapse. Specifically, those with four weeks of symptoms had a 28% chance of relapse while those with 12 weeks of symptoms had an 86% chance of relapse in the two years following remission.
These results were measured while considering other factors such as disability, physical health, and antidepressant medication, and were found to be consistent regardless. But cognitive health and medical conditions were significantly associated with relapse during the first 6 months after treatment and remission. Kiosses believes that this study underscores the importance of continued care even after treatment. “Although the mechanisms relating subsyndromal symptoms to recurrence are unclear, it is prudent to remain clinically vigilant during the first few months after remission of late-life depression,” said Kiosses.
Reference:
D, N. Kiosses, and S. Alexopoulos G. The prognostic significance of subsyndromal symptoms emerging after remission of late-life depression. Psychological medicine 43.2 (2013): 341-50. ProQuest Research Library. Web. 30 Jan. 2013.
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