Depression and comorbid illness in elderly primary care patients: Impact on multiple domains of health status and well-being

Polly Hitchcock Noël, John W. Williams, Jürgen Unützer, Jason Worcbel, Shuko Lee, John Cornell, Wayne Katon, Linda H. Harpole, Enid Hunkeler

Research output: Contribution to journalArticlepeer-review

164 Scopus citations


PURPOSE: Our objective was to examine the relative association of depression severity and chronicity, other comorbid psychiatric conditions, and coexisting medical illnesses with multiple domains of health status among primary care patients with clinical depression. METHODS: We collected cross-sectional data as part of a treatment effectiveness trial that was conducted in 8 diverse health care organizations. Patients aged 60 years and older (N = 1,801) who met diagnostic criteria for major depression or dysthymia participated in a baseline survey. A survey instrument included questions on sociodemographic characteristics, depression severity and chronicity, neuroticism, and the presence of 11 common chronic medical illnesses, as well as questions screening for panic disorder and posttraumatic stress disorder. Measures of 4 general health indicators (physical and mental component scales of the SF-12, Sheehan Disability Index, and global quality of life) were included. We conducted separate mixed-effect regression linear models predicting each of the 4 general health indicators. RESULTS: Depression severity was significantly associated with all 4 indicators of general health after controlling for sociodemographic differences, other psychological dysfunction, and the presence of 11 chronic medical conditions. Although study participants had an average of 3.8 chronic medical illnesses, depression severity made larger independent contributions to 3 of the 4 general health indicators (mental functional status, disability, and quality of life) than the medical comorbidities. CONCLUSIONS: Recognition and treatment of depression has the potential to improve functioning and quality of life in spite of the presence of other medical comorbidities.

Original languageEnglish (US)
Pages (from-to)555-562
Number of pages8
JournalAnnals of family medicine
Issue number6
StatePublished - Nov 2004


  • Depression
  • Health status
  • Primary health care
  • Quality of life

ASJC Scopus subject areas

  • Family Practice


Dive into the research topics of 'Depression and comorbid illness in elderly primary care patients: Impact on multiple domains of health status and well-being'. Together they form a unique fingerprint.

Cite this