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Daniel Polsky, PhD; Jalpa A. Doshi, PhD; Steven Marcus, PhD; David Oslin, MD; Aileen Rothbard, ScD; Niku Thomas, MD; Christy L. Thompson, MS

Arch Intern Med. 2005;165:1260-1266.

Background  This study examines the risk of development of significant depressive symptoms after a new diagnosis of cancer, diabetes, hypertension, heart disease, arthritis, chronic lung disease, or stroke.

Methods  The study used 5 biennial waves (1992-2000) of the Health and Retirement Study to follow a sample of 8387 adults (aged 51 to 61 years and without significant depressive symptoms in 1992) from 1994 to 2000. Time-dependent Cox regression models estimated adjusted hazard ratios (HRs) for an episode of significant depressive symptoms after a new diagnosis for each of the 7 medical conditions.

Results  Within 2 years of initial diagnosis, subjects with cancer had the highest hazard of depressive symptoms (HR, 3.55; 95% confidence interval [CI], 2.79-4.52), followed by subjects with chronic lung disease (HR, 2.21; 95% CI, 1.64-2.79) and heart disease (HR, 1.45; 95% CI, 1.09-1.93). The hazard for depressive symptoms for most of these diseases decreased over time; however, subjects with heart disease continued to have a higher risk for depressive symptoms even 2 to 4 years and 4 to 8 years after diagnosis, and a significantly higher hazard for depressive symptoms developed for persons with arthritis 2 to 4 years after diagnosis (HR, 1.46; 95% CI, 1.11-1.92).

Conclusion  The findings identify several high-risk patient groups who might benefit from depression screening and monitoring to improve health outcomes in this vulnerable population facing new medical illnesses.

Author Affiliations: Division of General Internal Medicine (Drs Polsky, Doshi, and Thomas and Ms Thompson), Geriatric and Addiction Psychiatry (Dr Oslin), and Center for Mental Health Policy and Services Research, Department of Psychiatry (Dr Rothbard), University of Pennsylvania Medical Center; School of Social Work, University of Pennsylvania (Dr Marcus); Philadelphia Veterans Administration Medical Center (Dr Oslin); and Leonard Davis Institute of Health Economics (Drs Polsky and Doshi and Ms Thompson), Philadelphia.

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