Coping and Depression in Older Persons

Abstract

In her thesis Coping and depression in late life, Guro Hanevold Bjørkløf examines the relations between experienced control, coping strategies and depression. Depression is the most common mood disorder among older persons. Factors increasing the risk for developing depression in later life can be difficult to modify. These factors are depression in earlier years, being female gender, bereavement, sleep disorders and to have a poorer level of functioning in daily life.

Treatment of depression in late life is as effective as in younger persons. In short-term, but not in the longer term, the prognosis after treatment is good. Of this reason, it is important to identify the factors affecting prognosis in a positive direction and that at the same time are modifiable.

In this study 122 deeply depressed patients from seven psychogeriatric hospital units in Norway were examined at admission to hospital. Questionnaires for control and coping strategies were answered. In-depth interviews were conducted with 18 of the patients. In addition, 106 older community-dwelling persons without depression were recruited as a reference group. The depressed patients were followed up after 12 months with a new assessment of depression.

The older patients´ experience of low control and low cognitive function were related to more symptoms of depression after one year. Lower functioning in daily life and use of active coping strategies at admission to hospital were also related to depression after one year. Experiencing deep depression was described by the patients as an immensely painful existence and the use of active coping strategies were probably less useful to this group.

This study shows that psychological factors as control and coping strategies may have importance to prognosis after treatment of depression. Interventions empowering older depressed patients should be part of treatment being offered in psychogeriatric hospital units.