Profiles of depressive symptoms in older adults diagnosed with major depression: latent cluster analysis.
To explore the underlying structure of symptom presentation in older adults with major depression by identifying homogeneous clusters of individuals based on symptom profiles.Secondary data analysis using latent class cluster analysis.Clinical Research Center for the Study of Depression in Later Life conducted at Duke University.Three hundred sixty-six patients age 60+ who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for major depression and were enrolled in a longitudinal naturalistic treatment study.Responses to the 10 items of the Montgomery-Asberg Depression Rating Scale at the time of study enrollment.The authors identified four latent clusters of older adults with major depression. Patients in Cluster 1 (47.2%) had mean scores of average severity for reported and apparent sadness and lassitude and low mean scores for reduced appetite. Patients in Cluster 2 (27.1%) had higher mean scores compared with Cluster 1 for all items, and particularly for apparent sadness. Patients in Cluster 3 (18.9%) had the lowest mean scores for both apparent and reported sadness, but a similar profile compared with Cluster 1 for inner tension, reduced sleep, reduced appetite, and concentration difficulties. Cluster 4 (6.8%) had the highest mean scores for each item. Both apparent and reported sadness accounted for a large amount of variance among the four clusters. Patients in Cluster 4 were more likely to have 12 or less years of education and/or one or more functional limitations.The heterogeneity in symptom presentation among older adults diagnosed with major depression can potentially inform the development of DSM-V.
Hybels, CF; Blazer, DG; Pieper, CF; Landerman, LR; Steffens, DC
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