The Socio-Demographic Characteristics of Depression and It’s Relationship With Vascular Diseases Among 65 Plus Patients; A Retrospective Record Control Study

Öz Aim; Vasküler depression proposes a reciprocal relationship between vascular diseasesand depression . Thus depressive symptoms inelderly patients might be caused by underlyingvascular mechanisms. This is a retrospectiverecord control study of sixty-five plus patientswho admitted to geropsychiatry outpatient unitof Ankara University Psychiatry Department.The aim of the study is to investigate thesociodemographic characteristics of depressionand it’s relationship with vascular diseases ingeriatric outpatients. First the previous literatureon this topic will be briefly summarised then theresults of the present study will be discussedwithin the frame of the previous literature.Method; The records of 508 patients whoadmitted to the gero-psychiatry unit for any reason were included in the study. The distrubutionof psychiatric disorders and sociodemographiccharacteristics of the patients with and withoutdepression were analysed. Then the groupswith and without vascular diseases were compared for depression rates. Results andDiscussion; Depression was the most frequentdisorder within the group. Lower rates ofdepression were found in the oldest old patientsand patinets who were retired. Higher depression rates were found in female patients. Levelof education and civil state of the patients wereunrelated to depression rates. The rates ofdepression were significantly higher in patientswith vascular diseases. The results of the studywere in line with the previous studies. Thesefindings may be parallel to vascular hypothesisof depression

___

Alan J, Thomas Rajesh N, Kalaria John T (2004) O’Brien Depression and Vascular Disease: what is the Relationship, Journal of Affective Disorders, 79, 81-95.

Alexopoulos GS, Young RC, Meyers BS (1993) Geriatric Depression: Age of Onset and Dementia. Biol. Psychiatry, 34, 141-145.

Alexopoulos GS, Meyers BS, Young RC, Campbell S, Silbersweig D, Charlson M (1997) ‘Vascular Depression’ Hypothesis. Arch. Gen. Psychiatry, 54, 915-922.

Alexopoulos GS, Meyers BS, Young RC, Kalayam B, Kakuma T, Gabrielle M, et al. (2000) Executive Dysfunction and Long-Term Outcomes of Geriatric Depression. Arch Gen Psychiatry, 57: 285- 90.

Angst F, Stassen HH, Clayton PJ, Angst J (2002) Mortality of Patients with Mood Disorders: Follow-Up Over 34– 38 Years. J. Affect. Disord. 68, 167-181.

Baldwin RC, Tomenson B (1995) Depression in Later Lfe. A Comparison of Symptoms and Risk Factors in Early and Late Onset Cases. Br. J. Psychiatry, 167, 649-652.

Brilman EI, Ormel J (2001) Life Events, Difficulties and Onset of Depression in Later Life. Psychol. Med. 31, 859-869.

Charlson M, Peterson JC (2002) Medical Comorbidity and Late Life Depression: What is Known and what are the Unmet Needs? Biol. Psychiatry 52, 226-235.

Colenda CC, Wagenaar DB, Mickus M, Marcus SC, Tanielian T, Pincus HA (2003) APA. Comparing Clinical Practice with Guideline Recommendations for the Treatment of Depression in Geriatric Patients: Findings From the APA Practice Research Network. Am J Geriatr Psychiatry. Nov-Dec;11(6): 604.

Cwikel J, Ritchie K (1989) Screening for Depression Among the Elderly in Israel: An Assessment of the Short Geriatric Depression Scale (S-GDS). Isr J Med Sci. Mar; 25(3): 131-7.

Elliott R, Sahakian BJ, McKay AP, Herrod JJ, Robbins TW, Paykel ES. (1996) Neuropsychological Impairments in Unipolar Depression: The Influence of Perceived Failure on Subsequent Performance. Psychol Med 26:975-89.

Frasure-Smith N, Lesperance F, Talajic M (1993) Depression Following Myocardial Infarction. Impact on 6-Month Survival. J. Am. Med. Assoc. 270, 1819-1825.

Gavard JA, Lustman PJ, Clouse RE (1993) Prevalence of Depression in Adults with Diabetes. An Epidemiological Evaluation. Diabetes Care, 16, 1167- 1178.

Greenwald BS, Kramer-Ginsberg E, Krishnan KR, Ashtari M, Auerbach C, Patel M (1998) Neuroanatomic Localization of Magnetic Resonance Imaging Signal Hyperintensities in Geriatric Depression. Stroke, 29, 613-617.

Hance M, Carney RM, Freedland KE, Skala J (1996) Depression in Patients with Coronary Heart Disease. A 12-Month Followup. Gen. Hosp. Psychiatry, 18, 61-65.

Henderson SA (2000) Epidemiology of Psychiatric Disorders in Kaplan&Sadock’s Comperhensive Textbook of Psychiatry, Geriatric Psychiatry, 51, 1B.

House A, Dennis M, Mogridge L, Warlow C, Hawton K, Jones L (1991) Mood Disorders in the Year After First Stroke. Br. J. Psychiatry, 158, 83-92.

Kumar A, Miller D, Ewbank D et al. (1993-1997) Quantitative Anatomic Measures and Comorbid Medical Illness in Late-Life Major Depression. Am. J. Geriatr. Psychiatry, 5, 15-25.

Laghrissi-Thode F, Wagner WR, Pollock BG, Johnson PC, Finkel MS (1997) Elevated Platelet Factor 4 and Beta-Thromboglobulin Plasma Levels in Depressed Patients with Ischemic Heart Disease. Biol. Psychiatry, 42, 290-295.

Lenore H, Kurlowicz T, Freida H, Outlaw T, Sarah J. Ratcliffe Y, and Lois K, Evans T (2005) An Exploratory Study of Depression Among Older African American Users of an Academic Outpatient Rehabilitation Program Archives of Psychiatric Nursing, Vol. 19, No. 1 (February), pp 3-9.

Lesser IM, Boone KB, Mehringer CM, Wohl MA, Miller BL, Berman NG. (1996) Cognition and white matter hyperintensities in older depressed patients. Am J Psychiatr, 153:1280-7.

Magni G, De Leo D, Schifano F (1985) Depression in Geriatric and Adult Medical Inpatients. J Clin Psychol. May; 41(3): 337-44.

McCrea D, Arnold E, Marchevsky D, Kaufman BM (1994) The Prevalence of Depression in Geriatric Medical Outpatients. Age Ageing. Nov; 23(6):465-7.

McCullough PK (1991) Geriatric Depression: Atypical Presentations, Hidden Meanings Geriatrics. Oct; 46(10):72-6.

Murphy E, Brown GW (1980) Life Events, Psychiatric Disturbance and Physical Illness Br J Psychiatry, 136; 326-338.

Mustafa C, Meltem H, Burcu BY, Neslihan D, Eylem SC, Servet A (2005) Depression and Concomitant Diseases in a Turkish Geriatric Outpatient Setting Archives of Gerontology and Geriatrics, 40 307-315.

Perel JM (1994) Geropharmacokinetics of Therapeutics, Toxic Effects and Complience in Schneider LS, Reynolds CF, Lebowitz BD (eds.) Diagnosis and Treatment in Late Life. Results of the NIH Consensus Development Conference, Washington DC, Amarican Psychiatric Pres; 245-257.

Rabkin JG, Charles E, Kass F (1983) Hypertension and DSMIII Depression in Psychiatric Outpatients. Am. J. Psychiatry, 140, 1072-1074.

Regier DA, Boyd JH, Rae DS, Burke JD, Locke BZ, Myers JK, Kramer M, Robins LN, George LK, Karno M (1988) One-Month Prevalence of Mental Disorders in the United States Based on Five Epidemiologic Catchment Area Sites. Arch Gen Psychiatry, 45: 977.

Reichman WE, Coyne AC, (1995) Depressive Symptoms in Alz- AJ Thomas et al. Journal of Affective Disorders 79 (2004) 81–95 94. Alzheimer’s Disease and Multi-Infarct Dementia. J. Geriatr. Psychiatry Neurol. 8, 96-99.

Robinson RG, Starr LB, Kubos KL, Price TR (1983) A Twoyear Longitudinal Study of Post-Stroke Mood Disorders: Fndings During the Initial Evaluation. Stroke, 14, 736-741.

Schulberg HCI McClelland M, Burns BJ (1987) Depression and Physical Illness the Prevelance, Causation and Diagnosis of Comorbidity, Clin Psychol Rev, 7;145-167.

Soares JC, Mann JJ (1997) The Anatomy of Mood Disorders-Review of Structural Neuroimaging Studies. Biol Psychiatry 41: 86-106.

Thomas AJ, Ferrier IN, Kalaria RN, Perry RH, Brown A, O’Brien JT, (2001) A Neuropathological Study of Vascular Factors in Late-Life Depression. J. Neurol. Neurosurg. Psychiatry 70, 83-87.

Williams SA, Kasl SV, Heiat A, Abramson JL, Krumholz HM, Vaccarino V (2002) Depression and Risk of Heart Failure Among the Elderly: A Prospective Community-Based Study. Psychosom. Med. 64, 6-12.