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Short-Term Stability of Diagnoses of Major and Minor Depression in Older Medical Inpatients

Received August 24, 2005; revised November 30, 2005; accepted December 5, 2005. From the Dept. of Psychiatry, St. Mary’s Hospital, and McGill Univ., Montreal, Québec, Canada. Send correspondence and reprint requests to Martin G. Cole, M.D., FRCPC, Dept. of Psychiatry, St. Mary’s Hospital, 3830 Lacombe Avenue, Montreal, Québec, Canada H3T 1M5. e-mail: martin.cole{at}ssss.gouv.qc.ca

The authors sought to determine the short-term stability of diagnoses of major and minor depression in older medical inpatients. The investigation was a test–retest design involving comparisons between different pairs of interviewers who assessed patients independently on medical wards of two acute-care, university-affiliated hospitals by use of the Diagnostic Interview Schedule (DIS) at intervals between 1 and 51 days. Patients were 380 cognitively-intact patients age 65, assessed twice with the DIS. Core depressive symptoms (depressed mood, loss of interest or pleasure) were more stable than the other depressive symptoms. The presence of moderate-to-severe depressive symptoms, moderate-to-severe disability, and depression symptoms of 6 months’ duration were associated with a higher short-term stability of diagnosis. Age, gender, language, education, rater, interval between assessments, baseline number of medications, medical comorbidity, severity of medical illness, acute physiology score, and cognitive functioning were not associated with short-term depression stability. Stability of diagnosis may be improved by emphasis on core depressive symptoms or the presence of more severe depressive symptoms, moderate-to-severe disability, and duration of symptoms 6 months.

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