Natural history of pharmacotherapy of older depressed community residents

Wilson, Kenneth; Copeland, J. R. M.; Taylor, Sophie; Donoghue, J.; McCracken, Cherie

doi:10.1192/bjp.175.5.439

Cited by 26 publications

(24 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…lower treatment rates focused on current rather than any use over a fixed period, which may explain our higher estimate. 34,36 Nonetheless, average monthly prevalence of antidepressant use (36-42%) was consistent with previous reports. [34][35][36][37][38] In our study, beneficiaries with a diagnosis of depression post-TBI were significantly less likely to receive antidepressant treatment compared with those with a diagnosis of depression pre-TBI.…”

Section: Discussionsupporting

confidence: 90%

“…32,33 Despite this, depression remains undertreated, with a range of 11%-57% of depressed older adults receiving any treatment. [34][35][36][37][38] In our study, 56% of those with a diagnosis of depression received treatment with antidepressants at least once during the year after diagnosis of depression. Previous studies reporting SSRI, selective serotonin reuptake inhibitors; OAD, other antidepressant; TBI, traumatic brain injury.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Patterns of Depression Treatment in Medicare Beneficiaries with Depression after Traumatic Brain Injury

Albrecht

Kiptanui

Tsang

et al. 2015

Journal of Neurotrauma

View full text Add to dashboard Cite

There are no clinical guidelines addressing the management of depression after traumatic brain injury (TBI). The objectives of this study were to (1) describe depression treatment patterns among Medicare beneficiaries with a diagnosis of depression post-TBI; (2) compare them with depression treatment patterns among beneficiaries with a diagnosis of depression pre-TBI; and (3) quantify the difference in prevalence of use. We conducted a retrospective analysis of Medicare beneficiaries hospitalized with TBI during 2006-2010. We created two cohorts: beneficiaries with a new diagnosis of depression pre-TBI (n = 4841) and beneficiaries with a new diagnosis of depression post-TBI (n = 4668). We searched for antidepressant medications in Medicare Part D drug event files and created variables indicating antidepressant use in each 30-day period after diagnosis of depression. We used provider specialty and current procedural terminology to identify psychotherapy in any location. We used generalized estimating equations to quantify the effect of TBI on receipt of depression treatment during the year after diagnosis of depression. Average monthly prevalence of antidepressant use was 42% among beneficiaries with a diagnosis of depression pre-TBI and 36% among those with a diagnosis post-TBI ( p < 0.001). Beneficiaries with a diagnosis of depression post-TBI were less likely to receive antidepressants compared with a depression diagnosis pre-TBI (adjusted odds ratio [OR] 0.87; 95% confidence interval [CI] 0.82, 0.92). There was no difference in receipt of psychotherapy between the two groups (OR 1.08; 95% CI 0.93, 1.26). Depression after TBI is undertreated among older adults. Knowledge about reasons for this disparity and its long-term effects on post-TBI outcomes is limited and should be examined in future work.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Patterns of Depression Treatment in Medicare Beneficiaries with Depression after Traumatic Brain Injury

Albrecht

Kiptanui

Tsang

et al. 2015

Journal of Neurotrauma

View full text Add to dashboard Cite

show abstract

“…13,17 . All primary care cohorts included patients who were 24,30 Only three studies reported on the course of dysthymic disorder according to DSM criteria. After 1 year, 47.2% was still depressed, 19 after 5 years 52.4% 26 and after 6 years 52%.…”

Section: Course Of Depressionmentioning

confidence: 99%

The prognosis of depression in older patients in general practice and the community. A systematic review

Licht-Strunk¹,

Windt

Marwijk³

et al. 2007

Family Practice

128

View full text Add to dashboard Cite

Licht-Strunk E, van der Windt DAWM, van Marwijk HWJ, de Haan M, Beekman ATF. The prognosis of depression in older patients in general practice and the community. A systematic review. Family Practice 2007; 24: 168-180.Background. Little is known about the prognosis of depression in older patients in general practice or the community.Objectives. To summarize available evidence on the course and prognostic factors of depression in older persons.Methods. We conducted a systematic, computerized search of Medline and PsycINFO. Manual search of references of included studies were done. Studies potentially eligible for inclusion were discussed by two reviewers. Methodological quality was independently assessed by two reviewers. Data regarding selection criteria, duration of follow-up, outcome of depression and prognostic factors were extracted.Results. We identified 40 studies reporting on four cohorts in general practice and 17 in the community. Of all, 67% were of high quality. Follow-up was up to 1 year in general practice and up to 10 years in the community. Information on treatment was hardly provided. About one in three patients developed a chronic course. Five cohorts used more than two measurements during follow-up, illustrating a fluctuating course of depression. Using a best evidence synthesis we summarized the value of prognostic indicators. General practice studies did not provide strong evidence for any factor. Community studies provided strong evidence for an association of baseline depression level, older age, external locus of control, somatic co-morbidity and functional limitations with persistent depression. Conclusion.Within the older population, age seems to be a negative prognostic factor, while older people are more likely to be exposed to most of the other prognostic factors identified.

show abstract

“…Benzodiazepines are often used to treat depressive symptoms inappropriately. 26 Other studies proposed that lithium may reduce the risk of relapse from recurrent depression. …”

Section: Other Studiesmentioning

confidence: 99%

“…26,27 In a followup study of community-dwelling older adults with depression only 10.9% took antidepressants, and 59.6% of those who took antidepressants were prescribed sub-therapeutic doses. 26 In another study 27 only 17% were treated and at three year follow up over half remained depressed. Benzodiazepines are often used to treat depressive symptoms inappropriately.…”

Section: Other Studiesmentioning

confidence: 99%

How long should older people take antidepressants to prevent relapse?

Spear¹

2002

Rev. Bras. Psiquiatr.

View full text Add to dashboard Cite

show abstract

Natural history of pharmacotherapy of older depressed community residents

Abstract: Trends of increasing antidepressant use have cost implications for primary care groups. Benzodiazepines may be mis-prescribed for treatment of depressive symptoms. Antidepressant users have poor outcome and follow-up.

Cited by 26 publications

References 13 publications

Patterns of Depression Treatment in Medicare Beneficiaries with Depression after Traumatic Brain Injury

Patterns of Depression Treatment in Medicare Beneficiaries with Depression after Traumatic Brain Injury

The prognosis of depression in older patients in general practice and the community. A systematic review

How long should older people take antidepressants to prevent relapse?

Contact Info

Product

Resources

About