The public health significance of later life depressive conditions in primary care settings is well recognized. In particular, the cross-sectional morbidity of depressive symptoms not meeting diagnostic criteria for major depression is greater than that of major depression alone. However, it is not known whether such conditions persist, lead to more severe depressive conditions, or have other long term morbidity. Accordingly, this revised R01 application proposes to test the hypothesis that patients with operationally defined minor/subsyndromal depression will have an intermediate 3-4 year outcome (as compared to non-depressed controls and to patients with major depression) in the following domains: depressive symptoms and diagnoses, medical illness severity, mortality, functional status, and health care utilization and costs. Also, the investigation will test hypotheses regarding the associations of specific theoretically based variables with the above outcomes. The predictors range across the biopsychosocial spectrum, including cerebrovascular risk factors, overall medical burden, functional status, the Five Factor Model of personality traits, social support, religiousness, and life events. The Study investigators Will recruit and follow 1000 subjects, age >= 65 years, from a variety of primary care sites serving the Monroe County, NY population. Study assessments will be derived from medical chart reviews and HCFA data as well as semi-structured patient interviews using validated measures such as the Structured Clinical Interview for DSM-IV and the Longitudinal Interval Follow-up Evaluation. Analysis of covariance will be used to examine group differences in outcomes. Multiple regression techniques will be used to determine the independent association of hypothesized predictors with outcomes. The results will directly inform future research, including identifying subjects for interventions as well as identifying theoretical models of depression pathogenesis that merit more definitive testing.
| Sörensen, Silvia; Chapman, Benjamin P; Duberstein, Paul R et al. (2017) Assessing future care preparation in late life: Two short measures. Psychol Assess 29:1480-1495 |
| Southerland, Jodi L; Slawson, Deborah L; Pack, Robert et al. (2016) Trait Hope and Preparation for Future Care Needs among Older Adult Primary Care Patients. Clin Gerontol 39:117-126 |
| Pickett, Yolonda R; Ghosh, Samiran; Rohs, Anne et al. (2014) Healthcare use among older primary care patients with minor depression. Am J Geriatr Psychiatry 22:207-10 |
| Hirsch, Jameson K; Walker, Kristin L; Wilkinson, Ross B et al. (2014) Family criticism and depressive symptoms in older adult primary care patients: optimism and pessimism as moderators. Am J Geriatr Psychiatry 22:632-5 |
| Hoerger, Michael; Chapman, Benjamin P; Prigerson, Holly G et al. (2014) Personality Change Pre- to Post- Loss in Spousal Caregivers of Patients with Terminal Lung Cancer. Soc Psychol Personal Sci 5:722-729 |
| Hatfield, Joshua P; Hirsch, Jameson K; Lyness, Jeffrey M (2013) Functional impairment, illness burden, and depressive symptoms in older adults: does type of social relationship matter? Int J Geriatr Psychiatry 28:190-8 |
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| Hirsch, Jameson K; Sirois, Fuschia M; Lyness, Jeffrey M (2011) Functional impairment and depressive symptoms in older adults: Mitigating effects of hope. Br J Health Psychol 16:744-60 |
| Cohen, Alex; Chapman, Benjamin P; Gilman, Stephen E et al. (2010) Social inequalities in the occurrence of suicidal ideation among older primary care patients. Am J Geriatr Psychiatry 18:1146-54 |
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