Clinical Depression in the Last Year in Life in Persons Dying from Non-Cancer Conditions—Real World Data

TL;DR

This study finds that 7.1% of people dying from non-cancer conditions had a clinical depression diagnosis in their final year, with notable differences by age, gender, and health conditions.

Contribution

The study provides real-world data on clinical depression prevalence in non-cancer end-of-life care using ICD-10 diagnoses.

Findings

Depression was diagnosed in 7.1% of non-cancer patients in their last year of life.

Women, younger individuals, and those with Parkinson’s or COPD had higher depression rates.

Depression was linked to more emergency room visits and psychiatric service use.

Abstract

Background/Objectives: Published prevalences of depression are mainly based on measurements of depressive symptoms, whereas data on clinical depressions are lacking. Our aim was to map the prevalence of ICD-10 diagnoses of depression made by physicians in routine healthcare, during the last year of life in non-cancer conditions and to study associations with clinical variables. Methods: A registry study on all persons in ordinary accommodation, dying in 2015–2023 in non-cancer conditions. Results: Of 62,228 persons dying from non-cancer conditions, 4391 (7.1%) were formally diagnosed with depression during the last year in life. Depression was significantly more common in women than in men, 8.0% vs. 6.3% (p < 0.001); adjusted odds ratio (aOR) 1.46 (95%CI 1.37–1.55). Prevalence of depression was highest in persons 18–44 years (18.3%) and lowest in persons >85 years old (5.7%) (p < 0.001); aOR 4.12 (95%CI 3.66–4.63). It was also more common in persons living in more affluent areas, aOR 1.19 (95%CI 1.10–1.29). The condition was most frequent in persons with Parkinson’s disease (9.4%) and COPD (8.2%). Depression was associated with more emergency room visits, 89.5% vs. 81.3% (p < 0.001), and visits in psychiatric services in the last year in life, 41.4% vs. 8.8% (p < 0.001). Depression was less prevalent in persons admitted to palliative care (p = 0.007). Conclusions: The highest frequencies were found in women, younger persons, and those living in affluent areas, but also in certain diagnoses such as Parkinson’s disease and COPD. Clinical depression in the last year of life is associated with more emergency room visits and utilization of psychiatric services.

Figures