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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH061429-05
Application #
6837686
Study Section
Special Emphasis Panel (ZRG1-BBBP-5 (01))
Program Officer
Muehrer, Peter R
Project Start
2001-02-10
Project End
2008-01-31
Budget Start
2005-02-04
Budget End
2008-01-31
Support Year
5
Fiscal Year
2005
Total Cost
$576,479
Indirect Cost
Name
University of Rochester
Department
Psychiatry
Type
Schools of Dentistry
DUNS #
041294109
City
Rochester
State
NY
Country
United States
Zip Code
14627
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Sörensen, Silvia; Mak, Wingyun; Chapman, Benjamin et al. (2012) The relationship of preparation for future care to depression and anxiety in older primary care patients at 2-year follow-up. Am J Geriatr Psychiatry 20:887-94
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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