[Prognosis of late-life depression: clinical and immunological features]

To study the outcomes of depression at a late age during a 3-year prospective follow-up in patients with various immunophenotypes.

A cohort of patients with depressive disorders who were treated in a gerontopsychiatric hospital and re-examined after 1 and 3 years. The group with immunophenotype A (with increased activity of leukocyte elastase (LE) and complex depressions, comorbid with anxiety and senesto-hypochondriac disorders) included 20 people: 6 men (30%) and 14 women (70%), median age was 68 years. A depressive episode (DE) was diagnosed in 13 patients (65%) with recurrent depressive disorder (RDD) and in 7 patients (35%) with bipolar affective disorder (BAD). The group with immunophenotype B (with reduced activity of LE and prolonged apathetic-adynamic depression) included 31 people: 10 men (32.3%) and 21 women (67.7%), the median age was 68 years. DE was diagnosed in 20 patients (64.5%) with RDD, 9 patients (29%) with BAD, and in 2 patients (6.5%) with a single DE. The patients were examined using clinical, psychometric, immunological and clinical- follow-up methods (after 1 and 3 years).

More favorable course of the disease with the formation of high-quality remission was observed in patients with immunophenotype A (95% of cases after 1 and 3 years; χ²=10.44; p=0.001 and χ²=11.97; p=0.001, respectively). In patients with immunophenotype B, an unfavorable course of the disease prevailed (83.9 and 87.1% of cases after 1 and 3 years) with the formation of low-quality remissions (with residual depressive disorders, the development of repeated depressive phases and chronification of depression).

The study revealed the relationship between clinical and biological features and the course of late-life depression.