Depression among elderly living in senior citizen homes - Investigation of a multifactorial model of depression

Background: The best way to describe the development of depression are multifactorial models in which volitional processes, i.e. regulation processes that transform cognitions into actions, play a central part. However, there are very few approaches to investigate such models among inhabitants of old people's residencies. Objective: Several variables related to depression were divided into two sets of predictors of depression: (1) predispositions of depression, (2) variables concerning the state of increased self-awareness. Methods: 100 inhabitants of old people's residencies have been questioned with a structured interview which included the tests ADS (german version of the Epidemiological Studies Depression Scala), FKK-SKI (self-efficacy), HAKEMP-90 (volitional self-regulation) and a newly developed questionnaire about perceived freedom. For one week subjects kept a diary of activities for self-observation. Results: Perceived freedom has proven to be independent of self-efficacy and volitional self-regulation. Depression was predicted by low physical fitness, little social support, a low degree of perceived freedom and a low degree of volitional self-regulation. Conclusions: Therapy and prevention of depression among inhabitants of old people's residencies should include both, promotion of volitional self-regulation and improvement of perceived freedom, because each of these factors contribute independently to the explanation of depression. Several possibilities to promote freedom in old people's residencies and in the therapy of depression with old people are proposed.