Diagnosis and Management of Late Life Depression: A Guide for the Primary Care Physician

Conn, David; Steingart, Allan

doi:10.2190/j309-ejmx-whrm-4uyg

Cited by 9 publications

(4 citation statements)

References 22 publications

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“…In agreement with previous studies [4,9,12], the presence of single medical conditions was found to be strongly associated with depression. The relative strength of the relationship, however, tended to differ by the type of medical conditions.…”

Section: Discussionsupporting

confidence: 93%

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Association of Comorbidity with Depressive Symptoms in Community-Dwelling Older Persons

Lee

Choi²,

Lee³

2001

Gerontology

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Background: Depression in later life poses a serious threat to mental health and well-being of older persons burdened with medical illnesses. Comorbid medical conditions independently, as well as through interactions, may influence the degree of depressive symptoms manifested by the elderly. Insight into the role medical comorbidity plays in the manifestation of depression may help to better address both physical and mental health care needs of the depressed elderly. Objective: To examine independent and synergistic effects of comorbid medical conditions in the presentation of depressive symptoms among older adults living in the community. Methods: Data from a national survey of community-dwelling older persons aged 60 years and over (n = 2,058) in Korea were used. The levels of depression were assessed using an eleven-item Center for Epidemiological Studies Depression Scale. Comorbidity was defined as the number of chronic medical conditions and the combination of disease pairs. Sociodemographic characteristics, self-rated health, physical functioning, history of hospital admission in the past year, frequency of contact with friends or neighbors, and emotional support were used as covariates. Results: Overall, persons with a medical condition compared to those without tended to show a higher depressive symptom score. Comorbidity, in terms of the number of medical conditions, tended to show a significant linear association with depression, controlling for confounders. More important, independent effects of medical conditions as well as a tendency to synergy among specific medical conditions were found, with notable gender differences. Conclusion: Given the significant but complex association of comorbid medical conditions with depressive symptoms in aged persons, clinicians should exercise care to address their physical and mental health needs within a common therapeutic context.

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Section: Discussionsupporting

confidence: 93%

“…Older people with depressive symptoms are more likely to have a negative view of their health [7,8]. Depression in later life is also known to be associated with increased morbidity, functional impairment, mortality, and health services use [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Association of Comorbidity with Depressive Symptoms in Community-Dwelling Older Persons

Lee

Choi²,

Lee³

2001

Gerontology

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“…6 It has begun to receive increasing research attention, 161,163-167 but further results are needed before definitive conclusions can be drawn. 6 It has begun to receive increasing research attention, 161,163-167 but further results are needed before definitive conclusions can be drawn.…”

Section: Combined and Sequential Drug And Nondrug Treatmentsmentioning

confidence: 99%

Pharmacological and Psychological Treatments for Depressed Older Patients: A Meta-analysis and Overview of Recent Findings

Gerson¹,

Belin²,

Kaufman³

et al. 1999

Harvard Review of Psychiatry

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A meta-analysis was carried out to evaluate data published between January 1974 and February 1998 comparing rates of treatment response and tolerability of pharmacological and psychological treatments for depression in persons over age 55. Drugs (tricyclic antidepressants, selective serotonin-reuptake inhibitors, and a mixed group of other drugs) were significantly better than placebo, with an average reduction in symptom severity of 48.0% versus 31.3% (analysis weighted by sample size; 50.6% vs. 21.4% unweighted). No single drug or group of drugs was superior in terms of efficacy, and no statistically significant differences in tolerability emerged between tricyclic antidepressants and selective serotonin-reuptake inhibitors, whether measured by total dropouts or by dropouts due to side effects. Compared to the data on pharmacological treatments, those for outcomes of psychological treatments are very limited. Existing data indicate that cognitive-behavioral, behavioral, and psychodynamic therapies are significantly better than placebo. In the current meta-analysis, response rates to these nondrug therapies did not differ significantly from those observed with tricyclic antidepressants or selective serotonin-reuptake inhibitors, but direct comparison data are insufficient for firm conclusions to be drawn about comparative efficacy. It is possible, even likely, that not only different subtypes of depression but also different patients vary in their treatment responses. However, lack of adequate data prevented the current meta-analysis from addressing these issues. Rigorously designed prospective studies on treatment outcome, taking into account the above differences, are urgently needed to provide robust data on which to base clinical recommendations for the treatment of depression in older patients.

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“…Depression causes deterioration in social functioning and quality of life, and is also related to an increase in diseases in the elderly (Conn and Steingart, 1997;Fried et al, 1998). Thus, it is important to detect depression in the elderly and to treat it promptly.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Beck Depression Inventory (BDI) in the Korean elderly population

Jo¹,

Park

Jo³

et al. 2006

Int J Geriat Psychiatry

132

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Diagnosis and Management of Late Life Depression: A Guide for the Primary Care Physician

Abstract: It is important to be vigilant for the variety of depressive presentations that occur in older primary care patients. Neurological causes of depression (such as stroke), suicide, and a longer time to recovery are all more frequent concerns in older depressed patients.

Cited by 9 publications

References 22 publications

Association of Comorbidity with Depressive Symptoms in Community-Dwelling Older Persons

Association of Comorbidity with Depressive Symptoms in Community-Dwelling Older Persons

Pharmacological and Psychological Treatments for Depressed Older Patients: A Meta-analysis and Overview of Recent Findings

Usefulness of Beck Depression Inventory (BDI) in the Korean elderly population

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