Claudia Sikorski1, Melanie Luppa2, Kathrin Heser3, Annette Ernst4, Carolin Lange4, Jochen Werle5, Horst Bickel6, Edelgard Mösch6, Birgitt Wiese7, Jana Prokein7, Angela Fuchs8, Michael Pentzek8, Hans-Helmut König9, Christian Brettschneider9, Martin Scherer4, Wolfgang Maier3, Siegfried Weyerer5, Steffi G Riedel-Heller2. 1. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany. Electronic address: Claudia.Sikorski@medizin.uni-leipzig.de. 2. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany. 3. Department of Psychiatry, University of Bonn, Bonn, Germany. 4. Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Germany. 5. Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany. 6. Department of Psychiatry, Technical University of Munich, Munich, Germany. 7. Institute for Biometrics, Hannover Medical School, Hannover, Germany. 8. Institute of General Practice, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany. 9. Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Abstract
BACKGROUND: In the revised version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) the Mood Disorder Workgroup for DSM-V the bereavement exclusion criterion for the diagnosis of major depression has been eliminated. AIM: To investigate the impact of bereavement on the incidence of depression and depressive symptoms in the elderly. METHOD: Participants over 75 years from the longitudinal German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe) that were still married at baseline were investigated (n=1,193). Data from four follow-ups (time frame: 6 years) were investigated. The response rate at baseline was 50.3%. Three clinical endpoints were analyzed: depressive symptoms according to Geriatric Depression Scale (1) GDS≥6, (2) GDS≥10, and (3) Major Depression (MD). The effect of loss was investigated using random-effects regression models. RESULTS: Experiencing a loss of spouse was predictive of a higher incidence in GDS≥6 (OR 4.52, 95% CI 2.6-7.9) and 10 (OR 5.59, 95% CI 1.8-17.0) even after adjusting for age, gender, impairment at baseline, and GDS score at baseline. Associations with MD were not significant (OR 1.77, 96% CI 0.9-3.5). CONCLUSIONS: Older adults experiencing the loss of their spouse are more likely to display elevated levels of depressive symptoms, that may reach a concerning level of severity.
BACKGROUND: In the revised version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) the Mood Disorder Workgroup for DSM-V the bereavement exclusion criterion for the diagnosis of major depression has been eliminated. AIM: To investigate the impact of bereavement on the incidence of depression and depressive symptoms in the elderly. METHOD:Participants over 75 years from the longitudinal German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe) that were still married at baseline were investigated (n=1,193). Data from four follow-ups (time frame: 6 years) were investigated. The response rate at baseline was 50.3%. Three clinical endpoints were analyzed: depressive symptoms according to Geriatric Depression Scale (1) GDS≥6, (2) GDS≥10, and (3) Major Depression (MD). The effect of loss was investigated using random-effects regression models. RESULTS: Experiencing a loss of spouse was predictive of a higher incidence in GDS≥6 (OR 4.52, 95% CI 2.6-7.9) and 10 (OR 5.59, 95% CI 1.8-17.0) even after adjusting for age, gender, impairment at baseline, and GDS score at baseline. Associations with MD were not significant (OR 1.77, 96% CI 0.9-3.5). CONCLUSIONS: Older adults experiencing the loss of their spouse are more likely to display elevated levels of depressive symptoms, that may reach a concerning level of severity.
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