Depression symptomology groups among middle and older adult emergency department patients

Middle and late life adults may present depression symptomology differently than the expected symptoms of depression. Clusters of common symptoms may be overlooked when determining the most appropriate treatment options, leading to a less than effective treatment. Investigation of these clusters is needed to better understand patterns of depressive symptomology among middle and late life adults.

Consent, demographics, self-report items and PHQ-9 items were administered to subjects. Latent class analysis (LCA), was used to determine groupings of patients based on PHQ-9 items. Demographics were compared across classes for additional information.

A total of 252 subjects aged 45-85 years old were enrolled. An LCA indicated that a 3 class solution explained the clusters endorsed: Low Concerns (35%), Many Concerns (34%), and Sleep and Fatigue Concerns (31%). Patients in the Low Concerns class were more likely to have private insurance compared to those in the Many Concerns class (57% vs 34%, p = 0.003). They also reported better general health (M = 2.39 vs M = 1.58, p < 0.001), and visited their PCP less frequently (M = 1.64 visits vs M = 3.31 visits, p = 0.004).

Recall bias may have been present due to self-report of symptoms which was a report based on a low threshold for endorsement of items. Future larger studies should utilize more response options.

LCA suggests there are three unique groupings of symptoms as reported by the PHQ-9. These clusters may be valuable in determining treatment options and designing interventions.