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The two-year course of late-life depression; results from the Netherlands study of depression in older persons
Open accessAbstract
BACKGROUND: We aimed to examine the course of depression during 2-year follow-up in a group clinically depressed older persons. Subsequently, we studied which socio-demographic and clinical characteristics predict a depression diagnoses at 2-year follow-up. METHODS: Data were used from the Netherlands Study of Depression in Older persons (NESDO; N = 510). Diagnoses of depression DSM-IV-TR criteria were available from 285 patients at baseline and at 2-year follow-up. Severity of the depressive symptoms, as assessed with the Inventory of Depressive Symptoms (IDS), was obtained from 6-monthly postal questionnaires. Information about socio-demographic and clinical variables was obtained from the baseline measurement. RESULT: From the 285 older persons who were clinically depressed at baseline almost half (48.4%) also suffered from a depressive disorder two years later. Patients with more severe depressive symptoms, comorbid dysthymia, younger age of onset and more chronic diseases were more likely to be depressed at 2-year follow-up. 61% of the persons that were depressed at baseline had a chronic course of depressive symptoms during these two years. CONCLUSIONS: Late-life depression often has a chronic course, even when treated conform current guidelines for older persons. Our results suggest that physical comorbidity may be candidate for adjusted and intensified treatment strategies of older depressed patients with chronic and complex pathology.
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![Figure 1 Course of depression (percentages). [Remission: at least the last two observations IDS score < 14; Intermittent: at least one of the observations IDS < 14 (not being the last two observations); Chronic depression, defined as all IDS scores > 14 and sub classified as: chronic mild to moderate depression, defined as all IDS scores between 14 and 26; chronic moderate to severe depression, defined as all IDS scores between 26 and 84; chronic depression with variable severity, defined as IDS scores varying between 14 to 84].](/paper-figures/3cef6723debe46aab071d484faab7eba/the-two-year-course-of-late-life-depression-results-from-the-netherlands-study-figure-1.jpg)
![Figure 2 Severity of depressive symptoms according to course during 2-year follow-up. [Remission: at least the last two observations IDS score < 14; Intermittent: at least one of the observations IDS < 14 (not being the last two observations); Chronic depression, defined as all IDS scores > 14 and sub classified as: chronic mild to moderate depression, defined as all IDS scores between 14 and 26; chronic moderate to severe depression, defined as all IDS scores between 26 and 84; chronic depression with variable severity, defined as IDS scores varying between 14 to 84].](/paper-figures/661796c74f554a4089fc4c6fbb45a400/the-two-year-course-of-late-life-depression-results-from-the-netherlands-study-figure-2.jpg)
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“The idiom 'thinking too much' denotes a broader mental health syndrome, with manifestations such as sadness, lack of motivation, poor concentration, sleep difficulties and irritability, perhaps similar to the construct of 'common mental disorders'. 112-117”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [115]
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“Background Late-life depression is a complex mood disorder with various etiological pathways [1] and high comorbidity with psychiatric and physical diseases, and cognitive decline [2-5].”
BackgroundThe Inventory of Depressive Symptomatology (IDS): Psychometric properties
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“Severity of the depressive symptoms was assessed with the Inventory of Depressive Symptoms (IDS) [27].”
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Kwok, M. K., Lee, S. Y., & Schooling, C. M. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.05.120 · Cited by 4
“Considering the chronic nature and fluctuating course (remission and recurrence) of depressive symptoms (Comijs et al., 2015), our model might not fully capture episodes of depressive symptoms during the 2-year follow-up period.”
Kleebthong, D., Chareonsuk, S., & Kristiansen, L. P. (2018) · Open Journal of Nursing · doi:10.4236/ojn.2018.81004 · Cited by 3
“One reason is because depression has a strong chance of recurring in older people [29].”
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“The Netherlands Study of Depression in Older Persons (NESDO) reported that only 18% of their participants diagnosed with major depressive disorder (MDD) had recovered after 2 years [15], despite having received psychopharmacological and psychotherapeutic treatment from primary or specialized mental health-care service…”
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Depression in patients with cerebral microangiopathy
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Interaction of chronic diseases and levels of mastery on the course of depression
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“This appears to be particularly true for LLD as shown in a recent longitudinal cohort study by Comijs et al.(1) in which approximately half of the patients diagnosed with depression also suffered from it at the 2-year follow-up.”
ResultBorza, T. (2017) · NORA - Norwegian Open Research Archives
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Promoting Healthy Aging Through Recognition and Treatment of Psychiatric Disorders in Older Adults
Yagudayeva, R., Matialeu, L., Schüpper, A. J., Onodera, K. M., & Sewell, D. D. (2019) · Springer eBooks · doi:10.1007/978-3-030-06200-2_24 · Cited by 2
Anxiety in late-life depression
van der Veen, D. C. (2021) · University of Groningen research database (University of Groningen / Centre for Information Technology) · doi:10.33612/diss.179793202
Determinants of adverse health outcomes in late-life depression
van den Berg, K. S. (2021) · University of Groningen research database (University of Groningen / Centre for Information Technology) · doi:10.33612/diss.192839589
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Self-citationMetaloproteinases de matriz e depressão: influência genética e impacto clínico
Pereira, S. C. (2021) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.17.2021.tde-14042022-125011
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Treatment-resistant depression in geriatrics
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“6,7 Given renewed interest in social factors affecting mental health, particularly in older adults, it is clinically compelling to clarify the effects of social support on late-life depression treatment, specifically antidepressant treatment response, and to examine whether influences of social…”
Spiegler, G., Su, Y., Li, M., Meng, X., & Schmitz, N. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120079
Peun, B., Chin, H. J., Choi, J.-Y., Kim, K.-I., & Choi, H. (2026) · PLoS ONE · doi:10.1371/journal.pone.0342924
“…demonstrated both lower RRT-free survival and reduced overall survival among participants with depressive symptoms; these findings are consistent with prior evidence showing that depression in older adults is associated with higher hospitalization rates, functional decline, and mortality [17,18].”
Maß, R., Backhaus, K., Pütz, K., & Unkelbach, B. K. (2026) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2026.101077
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“…including pharmaco-therapy and psychotherapy, often show diminished efficacy in older adults, with studies reporting recovery rates as low as 18% over two years, compared to around 80% in younger adults (Calati et al., 2012; Comijs et al., 2015; Spijker et al., 2002; Schaakxs et al., 2018).”
Self-citationStratmann, M. W., König, H.-H., & Hajek, A. (2026) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2026.106310
Metadata
- Authors
- Comijs, H. C., Nieuwesteeg, J., Kok, R., van Marwijk, H. W., van der Mast, R. C., Naarding, P., Voshaar, R. C. O., Verhaak, P., de Waal, M. W., & Stek, M. L.
- Affiliations
- Amsterdam Public Health (NL)
- GGZ inGeest (NL)
- Parnassia Groep (NL)
- GGNet (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Comijs, Hannie C
- Venue
- BMC Psychiatry
- Published
- 2015-02-12
- Volume
- 15
- Issue
- 1
- Pages
- 20-20
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC4329675
- OpenAlex
- W2059949121
- Cited by
- 136
- References
- 47
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 4 · 2023: 10 · 2022: 15 · 2021: 19 · 2020: 9 · 2019: 16 · 2018: 19 · 2017: 14 · 2016: 14 · 2015: 3
- FWCI
- 17.81
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Leiden Repository (Leiden University) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Research Explorer (The University of Manchester) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- Vrije Universiteit Amsterdam
- Fonds NutsOhra (0701-065, project 0701‐065)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- geriatric depression, course of depression, older adults, chronic depression, depression severity, dysthymia, age of onset, comorbidities, chronic physical illness, predictors of recurrence
- MeSH terms
- Aged, Aged, 80 and over, Chronic Disease, Depression, Depressive Disorder, Female, Humans, Male, Middle Aged, Netherlands, Personality Inventory, Surveys and Questionnaires, Recurrence, Comorbidity, Treatment Outcome, Dysthymic Disorder
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