Bulgarian Journal of Psychiatry, 2021; 6(2):6-13
CLINICAL AND DIAGNOSTIC ASPECTS OF LONELINESS IN LATE LIFE DEPRESSION, REQUIRING INPATIENT TREATMENT
Vessela Stoyanova, Jacklin Natzkova
Department of Psychiatry and Medical Psychology, Medical University – Sofia
Aim: To assess loneliness in hospitalized patients with late life depression (LLD) and its correlation with socio‐demographic and clinical characteristics.
Method: The study had a cross‐sectional design, for two years (01.11.2015‐01.11.2017) and all elderly patients who were hospitalized in UMHAT „Aleksandrovska” with diagnosis depression were included. The patients were assessed sociodemographically and psychometrically with Hamilton Depression Rating Scale – 24 items (HDRS24) and its cognitive subscale (HDRScog); Geriatric Depression Rating Scale – 15 items (GDS15) and its suicide subscale (GDSsuic); scale assessing subjective cognitive dysfunction – Perceived Deficits Questionnaire – 5 items (PDQ‐D5) and scale evaluating loneliness – the University of California, Los Angeles Loneliness Scale (UCLA‐LS). The data were compared with a control group and were processed with the IBM SPSS Statistics 25.0. Results: Three diagnostic groups were formed: Late‐onset depression (LOD, n=29), Recurrent depressive disorder (RDD, n=29) and Bipolar depression (BD, n=22). All three groups did not differ in clinical severity but the cognitive dysfunctions, assessed with HDRScog and PDQ‐D5 were more pronounced in BD. In RDD female sex (р=0,043) and lack of social support (р=0,001) had a significant impact on loneliness. Loneliness correlated with HDRS24 (r=0,628), HDRScog (r=0,625), GDS15 (r=0,580) and GDSsuic (r=0,513) in RDD and with GDS15 (r=0,574), GDSsuic (r=0,597) and PDQ‐D5 (r=0,543) in LOD. In BD a statistically significant correlation was found only with PDQ‐D5 (r=0,508).
Conclusion: Loneliness correlates with the clinical severity and suicide ideations and is the main part of the clinical characteristics of unipolar depression. A similar correlation model between LOD and RDD is established. In RDD female sex and lack of social support are significant risk factors for more pronounced loneliness. In BD loneliness correlates only with subjectively perceived cognitive dysfunction.
Key words: depression, late life, loneliness, cognitive dysfunction