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Predicting Diagnosed Depression and Anti-depressant Treatment in Institutionalized Older Adults by Symptom Profiles: A Closer Look at Anhedonia and Dysphoria*

Published online by Cambridge University Press:  31 March 2010

Michael J. Stones
Affiliation:
Lakehead University
Leah D. Clyburn
Affiliation:
Lakehead University
Margaret C. Gibson
Affiliation:
Parkwood Hospital, London, ON
M. Gail Woodbury
Affiliation:
Lawson Health Research Institute, London, ON
Corresponding
E-mail address:

Abstract

The purpose of this study was to examine the relationships of diagnosis and treatment of depression with anhedonic and dysphoric symptom presentation, using the Minimum Data Set 2.0. Participants were from two sectors of long-term care: 70 nursing home residents and 92 residents in a Veterans' Care Service. The samples differed in their sex distribution and in cognition. A series of logistic regressions that controlled for demographics, type of facility, and cognition showed that dysphoric symptoms predicted diagnosed depression, whereas anhedonic symptoms predicted anti-depressant medication use without a concomitant diagnosis. The findings are consistent with a hypothesis that, in long-term care settings, anhedonic symptoms contribute less to a diagnosis of depression than do dysphoric symptoms. However, findings that anhedonic symptoms relate to treatment have implications for care-planning protocols.

Résumé

L'objectif de cette étude est d'analyser les liens qui existent entre le diagnostic et le traitement de la dépression dysphorique-anhédonique, au moyen du Minimum Data Set 2.0. Les participants provenaient de deux secteurs des soins de longue durée : 70 vivaient en maison de retraite et 92 dans un centre de soins pour anciens combattants. Les échantillons étaient différents pour ce qui est de la distribution sexuelle et la cognition. Une série de régressions logistiques mesurant les données démographiques, le type d'infrastructure et la cognition montrent que les symptômes dysphoriques permettent de prédire la dépression diagnostiquée, tandis que les symptômes anhédoniques permettent de prédire l'utilisation d'antidépresseurs sans diagnostic concomitant. Les résultats sont compatibles avec l'hypothèse que, dans des contextes de soins de longue durée, les symptômes anhédoniques contribuent dans une moindre mesure au diagnostic de la dépression que les symptômes dysphoriques. Cependant, les résultats qui indiquent que les symptômes anhédoniques sont liés au traitement ont une incidence sur les protocoles de programmation des soins.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2006

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Footnotes

*

The authors would like to acknowledge a grant in support of this work from the Parkwood Hospital Foundation, London, Ontario.

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Predicting Diagnosed Depression and Anti-depressant Treatment in Institutionalized Older Adults by Symptom Profiles: A Closer Look at Anhedonia and Dysphoria*
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