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DOI: 10.1055/s-0034-1387028
The role of spousal loss in the development of depressive symptoms in the elderly – implications for diagnostic systems
Background: For the revised version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) the Mood Disorder Workgroup for DSM-V will entail the elimination of the bereavement exclusion criterion for the diagnosis of major depression.
Aim: To investigate the impact of bereavement on the indidence of depression and depressive symptoms in the elderly.
Method: Participants over 75 years from the longitudinal German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe) that were still married at baseline were investigated (n = 1,193). Data from four follow-ups (time frame: 6 years) were investigated. The response rate at baseline was 50.3%. Three clinical endpoints were analyzed: depressive symptoms according to Geriatric Depression Scale (1) GDS ≥ 6; (2) GDS ≥ 10; and (3) Major Depression (MD). The effect of loss was investigated using random-effects regression models.
Results: Experiencing a loss of spouse was predictive of a higher incidence in GDS ≥ 6 (OR 4.52, 95% CI 2.6 – 7.9) and 10 (OR 5.59, 95% CI 1.8 – 17.0) even after adjusting for age, gender, impairment at baseline, and GDS score at baseline. Associations with MD were not significant (OR 1.77, 96% CI 0.9 – 3.5).
Conclusions: Older adults experiencing the loss of their spouse are more likely to display elevated levels of depressive symptoms, that may reach a concerning level of severity.