Elders with first psychiatric hospitalization for depression

Objective: Little is known about the first psychiatric hospitalization episode of older adults with depression. The purpose of this study is to describe the proportion and characteristics of first-time inpatients admitted for late-life depression. Methods: Guided by the Network Episode Model and the Andersen model, this study identifies and compares the characteristics of depressed older adults with (n=108) and those without (n=77) prior psychiatric hospitalization, upon admission into the geropsychiatric unit, using logistic regression. Data on a lifetime history of inpatient psychiatric treatment, clinical characteristics, demographics, social resources, and psychosocial/medical service use were obtained from patients' medical records and self-reports. Results: Compared with patients who had prior psychiatric admission, first-time inpatients were associated with having: (1) late-onset depression (OR=14.99); (2) no lifetime psychotic symptoms (OR=0.21); (3) lower scores on the Brief Psychiatric Rating Scale (BPRS) at admission (OR=0.96); (4) higher numbers of doctors seen (OR=1.46); and (5) lower use of senior centers 6 months prior to the admission (OR=0.12). Conclusions: Depressed older adults' prior psychiatric inpatient service utilization is closely related to their past and current psychiatric needs. Also, the two groups show significant differences in health and social service use prior to the psychiatric hospitalization. However, severity of depression at admission was not different.