Protection from clinical depression in medical long‐term care facilities: Evidence for psychologic adaptation in cognitively intact patients

Abstract

SUMMARYA recent study in a medical long-term care facility (LTCF) population demonstrated evidence of psychologic adaptation in a predominantly demented population. We have also reported evidence of such adaptation which lowered the risk of depression in an LTCF sample. T h e present study extends the adaptational variables for depression compares areas of agreement between the dementia and depression studies, rcvicws the adaptational construct, and suggests clinical applications targeted to primary prevention of depression in this setting.KEY woms-Depression, nursing facility, long-term care facility, psychologic adaptation, coping, risk factors, life satisfaction, expectations, relocation, prevention. group psychotherapy.The two most common psychiatric illnesses in medical long-term care facilities (LTCFs) are cognitive disorders (dementia) and affective disorders (depression). A recent study has documented the occurrence of naturai psychologic adaptaLion processes in a largely demented population (Brant el al., German et al., 1992). We have also found evidence that adaptive processes occur which lower the risk of becoming cIioically depressed. Our cvidence was initially contained in a multivariate set of seven predepression risk variables that successfully discriminated depressed from non-depressed groups with excellent overall accuracy {about 9QX) (Foster and CataIdo, 1993 Institution andsubjectsThe research was conducted at Goldwater Memorial Hospital (GMH), a 912-bed medical LTCF, which is part of the New York City municipal hospital system. Patients were excluded if they were less than 20 years old, non-English speaking, deaf, aphasic, significantly cognitively impaired, unable

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How long should older people take antidepressants to prevent relapse?

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