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Original Investigation
February 23, 1998

Depressed Mood and Survival in Seriously Ill Hospitalized Adults

Author Affiliations

From the MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Drs Roach, Dawson, and Schubert); the University of Virginia School of Medicine at Charlottesville (Dr Connors); the University of California at Los Angeles (Dr Wenger); The Johns Hopkins University, Baltimore, Md (Dr Wu); the University of Cincinnati Medical Center, Cincinnati, Ohio (Dr Tsevat); the University of Tennessee College of Medicine, Chattanooga Unit (Dr Desbiens); and the University Hospitals of Cleveland, Cleveland, Ohio (Dr Covinsky).

Arch Intern Med. 1998;158(4):397-404. doi:10.1001/archinte.158.4.397

Objectives  To assess the relationship among depressed mood, physical functioning, and severity of illness and to determine the relationship between depressed mood and survival time, controlling for severity of illness, baseline functioning, and characteristics of patients.

Methods  Prospective cohort study of data for 3529 seriously ill hospitalized adults who received care at 5 tertiary care teaching hospitals and who completed a depressed mood assessment 7 to 11 days after admission to the study. The Profile of Mood States depression subscale was used to assess depressed mood. A stratified Cox proportional hazards model was used to assess the independent effect of depressed mood on survival time, adjusting for demographic characteristics of patients and health status.

Results  Greater magnitudes of depressed mood were associated with worse levels of physical functioning (r=0.151; P<.001) and more severity of illness. Depressed mood was associated with reduced survival time after adjusting for patient demographics and health status (hazards ratio, 1.134; 95% confidence interval, 1.071-1.200; P≤.001).

Conclusion  Seriously ill patients should be assessed for the presence of depressed mood even if they have not been given a diagnosis of depression. Further study is needed to determine whether interventions aimed at relieving depressed mood may improve prognosis.