COPING AND DEPRESSION IN CHRONICALLY ILL HOSPITALIZED ELDERLY PATIENTS

The author hypothesized that depressive symptoms in chronically ill hospitalized elderly patients would be related not only to descriptive factors but also to appraisal and individual coping responses. Eighty elderly hospitalized medical inpatients (50-98 years) with chronic physical diseases who were not expected to die during hospitalization were assessed by the Ways of Coping Checklist and the Montgomery-Asberg Depression Rating Scale. No statistical significant relationships were found between illness variables, sociodemographic variables, or problem-focused coping scores and depressive symptoms. There were, however, modest but significant correlations between secondary appraisals of having to hold oneself back from the situation, emotion-focused coping scores (r=0.27; p=0.01), perceived mental health the year before admittance, and depressive symptoms. This study suggests that depressive symptoms in chronically ill hospitalized elderly patients reflect an underlying appraisal of having to hold back from the situation (helplessness and powerlessness), which to a large extent reflects emotion-focused coping tendencies in responding to stressful events in general. This type of appraisal may reduce the probability that the staff will identify depressive symptoms in hospitalized medically ill elderly patients. Considering the increased morbidity and mortality associated with untreated depression in the medically ill, the use of trained nurses to detect depression may be the answer to this problem.