Course of late-life depression in China is chronic and unremitting

Abstract

Objective: The world's largest aging population resides in China. Depressive disorders represent a public health problem among older adults in China; however, little is known about the course and natural outcomes with routine treatment in primary care.

Methods: We examined the one-year naturalistic course of depressive symptoms in older adult Chinese primary care patients (Hangzhou, China).

Findings: We found slight improvement among most of the older adults who initially presented with mild or subsyndromal depressive symptoms, but marked increase in severity in one group of initially mildly depressed older adults; a lack of improvement among all older adults with severe initial presentations. Greater physical illness burden, lower functional capacity, and lower family support were associated with greater initial depressive symptom severity and lack of improvement over time.

Conclusion: The naturalistic course of depressive illness in older adult primary care patients in urban China is typically chronic and unremitting for those with severe symptoms and slowly improving for those with milder symptoms. Because access to specialty mental health care is limited, treatments for late-life depression need to be developed that can be effectively and feasibly implemented in Chinese primary care practices.

Keywords: China; depression; geriatrics; primary care.