Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
Vascular Pathology and Trajectories of Late-Life Major Depressive Disorder in Secondary Psychiatric Care. / Musliner, Katherine L; Zandi, Peter P; Liu, Xiaoqin; Laursen, Thomas M; Munk-Olsen, Trine; Mortensen, Preben B; Eaton, William W.
In: The American Journal of Geriatric Psychiatry, Vol. 26, No. 3, 2018, p. 386-395.Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
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TY - JOUR
T1 - Vascular Pathology and Trajectories of Late-Life Major Depressive Disorder in Secondary Psychiatric Care
AU - Musliner, Katherine L
AU - Zandi, Peter P
AU - Liu, Xiaoqin
AU - Laursen, Thomas M
AU - Munk-Olsen, Trine
AU - Mortensen, Preben B
AU - Eaton, William W
N1 - Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
PY - 2018
Y1 - 2018
N2 - OBJECTIVE: To examine 5-year trajectories of psychiatrist-treated late-life major depressive disorder (MDD), and evaluate whether previous vascular pathology is associated with more severe trajectories of late-life MDD.METHODS: Data were obtained from nationally representative civil, psychiatric, hospital, and prescription registers in Denmark. The sample included 11,092 older adults (≥60 years) who received their first diagnosis of MDD in a psychiatric facility in Denmark between 2000 and 2007. Trajectories of inpatient or outpatient contact at psychiatric hospitals for MDD over the 5-year period following index MDD diagnosis were modeled using latent class growth analysis. Measures of vascular disease (stroke, heart disease, vascular dementia) and vascular risk factors (hypertension, diabetes) were defined based on medication prescriptions and hospital-based diagnoses. Other predictors included demographic characteristics and characteristics of the index MDD diagnosis.RESULTS: The final model included 4 trajectories with consistently low (66% of the sample), high decreasing (19%), consistently high (9%), and moderate fluctuating (6%) probabilities of contact at a psychiatric hospital for MDD during the 5-year period following the index MDD diagnosis. We found no significant associations between any form of vascular pathology and trajectory class membership. Relative to the consistently low class, older age, greater severity and >12 months of prior antidepressant medication use predicted membership in the other three classes.CONCLUSIONS: A notable proportion (34%) of individuals diagnosed with MDD in late-life require secondary psychiatric treatment for extended time periods. We did not find evidence that vascular pathology predicts hospital contact trajectories in secondary-treated late-life MDD.
AB - OBJECTIVE: To examine 5-year trajectories of psychiatrist-treated late-life major depressive disorder (MDD), and evaluate whether previous vascular pathology is associated with more severe trajectories of late-life MDD.METHODS: Data were obtained from nationally representative civil, psychiatric, hospital, and prescription registers in Denmark. The sample included 11,092 older adults (≥60 years) who received their first diagnosis of MDD in a psychiatric facility in Denmark between 2000 and 2007. Trajectories of inpatient or outpatient contact at psychiatric hospitals for MDD over the 5-year period following index MDD diagnosis were modeled using latent class growth analysis. Measures of vascular disease (stroke, heart disease, vascular dementia) and vascular risk factors (hypertension, diabetes) were defined based on medication prescriptions and hospital-based diagnoses. Other predictors included demographic characteristics and characteristics of the index MDD diagnosis.RESULTS: The final model included 4 trajectories with consistently low (66% of the sample), high decreasing (19%), consistently high (9%), and moderate fluctuating (6%) probabilities of contact at a psychiatric hospital for MDD during the 5-year period following the index MDD diagnosis. We found no significant associations between any form of vascular pathology and trajectory class membership. Relative to the consistently low class, older age, greater severity and >12 months of prior antidepressant medication use predicted membership in the other three classes.CONCLUSIONS: A notable proportion (34%) of individuals diagnosed with MDD in late-life require secondary psychiatric treatment for extended time periods. We did not find evidence that vascular pathology predicts hospital contact trajectories in secondary-treated late-life MDD.
KW - Journal Article
KW - CIVIL REGISTRATION SYSTEM
KW - DEVELOPMENTAL TRAJECTORIES
KW - POPULATION
KW - REGISTER
KW - SAS PROCEDURE
KW - RISK-FACTORS
KW - trajectories
KW - NATURAL-HISTORY
KW - vascular disease
KW - Major depression
KW - DISEASE
KW - HYPOTHESIS
KW - COHORT
KW - vascular risk factors
KW - Follow-Up Studies
KW - Humans
KW - Middle Aged
KW - Male
KW - Registries/statistics & numerical data
KW - Aged, 80 and over
KW - Female
KW - Hospitals, Psychiatric/statistics & numerical data
KW - Depressive Disorder, Major/classification
KW - Patient Admission/statistics & numerical data
KW - Comorbidity
KW - Risk Factors
KW - Secondary Care/statistics & numerical data
KW - Denmark/epidemiology
KW - Vascular Diseases/epidemiology
KW - Aged
UR - http://www.scopus.com/inward/record.url?scp=85028330057&partnerID=8YFLogxK
U2 - 10.1016/j.jagp.2017.07.006
DO - 10.1016/j.jagp.2017.07.006
M3 - Journal article
C2 - 28807498
VL - 26
SP - 386
EP - 395
JO - The American Journal of Geriatric Psychiatry
JF - The American Journal of Geriatric Psychiatry
SN - 1064-7481
IS - 3
ER -