Mild depressive symptoms in older U.S. veterans: Prevalence, correlates, and psychiatric and functional burden

Mild depressive symptoms are more prevalent than threshold-level symptoms of depression. However, there is limited epidemiologic and clinical data among veterans for mild depressive symptoms. We examined the prevalence, correlates, and psychiatric and functional burden of mild depressive symptoms among older U.S. veterans. We analyzed data cross-sectionally from 2979 older veterans (age 60+) who participated in the nationally representative National Health and Resilience in Veterans Study. Depressive symptoms were assessed using the Patient Health Questionnaire-2 and categorized as none, mild, or a positive PHQ-2 screen. Weighted analyses and multivariable regression models examined associations with psychiatric disorders, suicidal behaviors, and functional measures. We found mild depressive symptoms (18.2%) were 4-times more prevalent than a positive PHQ-2 screen (4.3%) and associated with substantially elevated odds of psychiatric and substance use disorders and suicidal behaviors. Greater depressive symptom severity was associated with progressively higher levels of psychiatric and functional burden. Mild depressive symptoms are prevalent and associated with significant psychiatric and functional burden among older U.S. veterans, underscoring importance of further assessment, monitoring, and evaluation if early interventions can improve outcomes.