The effects of antidepressant medication adherence as well as psychosocial and clinical factors on depression outcome among older adults

Bosworth, Hayden B.; Voils, Corrine I.; Potter, Guy G.; Steffens, David C.

doi:10.1002/gps.1852

Cited by 56 publications

(41 citation statements)

References 47 publications

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“…A growing body of literature has also shown that these psychosocial factors influence depressive symptoms even in the context of pharmacotherapy (e.g., Bosworth et al, 2008; Pedrelli et al, 2008). Additionally, some earlier studies suggested that ethnicity might play a role in treatment outcomes of those undergoing pharmacotherapy for depression (e.g., Wagner et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

“…Exposure to various life stressors and chronic interpersonal stress has been consistently linked to the onset and course of major depression (Hammen, 2003; Kendler et al, 1999; Kendler et al, 2004; Kendler et al, 1997; see Kessler, 1997 for a review). However, the evidence linking stress to antidepressant response has been mixed, with some studies suggesting that there is no relationship between stress and depression in the context of antidepressant treatment (Bosworth et al, 2008), some showing that stress is associated with worse treatment outcomes (Mazure et al, 2000; Pedrelli et al, 2008; Tomaszewska et al, 1996), and others suggesting that interpersonal stress is associated, counter-intuitively, with better treatment outcomes (Sherbourne et al, 2004; Vallejo et al, 1991). …”

Section: Introductionmentioning

confidence: 99%

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Support and Undermining in Interpersonal Relationships Are Associated with Symptom Improvement in a Trial of Antidepressant Medication

Joseph¹,

Myers²,

Schettino³

et al. 2011

Psychiatry: Interpersonal and Biological Processes

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The purpose of this study was to investigate the relationships of chronic stress, social undermining, and social support with symptom reduction and remission in depressed patients treated with antidepressant medication (citalopram), and to determine whether these relationships were moderated by ethnicity. A sample of 301 treatment-seeking adult patients with non-psychotic depression, including 169 African-American and 132 Caucasian men and women, were enrolled in an eight week, dose escalation clinical trial. Intent-to-treat analyses indicated that, consistent with expectations, more baseline social support was associated with greater symptom reduction and higher likelihood of remission, especially at higher levels of social undermining. Additionally, increases in social support from baseline to last visit were associated with more symptom reduction and higher likelihood of remission. However, contrary to expectations, higher levels of baseline social undermining were associated with more symptom reduction in Caucasians, but not in African-Americans. Results supported the treatment enhancing effect of available social support at the beginning of treatment and over the course of treatment. Efforts to enhance social support for patients on antidepressants should be considered as part of comprehensive treatment.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Support and Undermining in Interpersonal Relationships Are Associated with Symptom Improvement in a Trial of Antidepressant Medication

Joseph¹,

Myers²,

Schettino³

et al. 2011

Psychiatry: Interpersonal and Biological Processes

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show abstract

“…Older adults usually present with mental health issues in primary care settings, where medications are much more readily available than psychotherapy and where quality of care is usually lower compared to specialty mental health settings (Wang et al 2005). Older adults do not adhere to psychotropic medication regimens (Bosworth et al 2008), and most prefer psychotherapy (Gum et al 2006). Meta-analyses have demonstrated that psychotherapy is effective (Pinquart et al 2006), and that older adults benefit from psychotherapy just as well as younger adults (Cuijpers et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Six-Month Utilization of Psychotherapy by Older Adults with Depressive Symptoms

Gum

Hirsch

Dautovich

et al. 2014

Community Ment Health J

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We explored psychotherapy utilization patterns for community-dwelling older adults with depressive symptoms identified during a statewide initiative designed for identifying risk of substance misuse. Individuals screening negative for substance misuse, but positive for depressive symptoms, agreed to participate in monthly interviews conducted over 6 months (n = 144). Results showed that 39 (27 %) received psychotherapy, of which nearly two-thirds reported four or fewer visits. Mental health counselors were the most frequently reported service providers (50–62.5 %). Location of service varied considerably. This study documents low rates of psychotherapy use and few visits. Current efforts to increase psychotherapy access are discussed.

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“…Within two years 60% of community-dwelling older adults with MDD became depressed again unless they were maintained on antidepressant medication [13]. Poor adherence to taking medications may account for a substantial proportion of treatment failures [14, 15]. Patients' compliance and continuous treatment are important.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Treatments Acceptable to Patients for Late‐Life Depression

Jogerst

Zheng

Vanderlip

2013

The Scientific World Journal

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Objectives. Describe older patients' perceptions about depression and characteristics associated with acceptance of treatments. Design. Cross-sectional study. Setting. Three primary care clinics in Iowa. Participants. Consecutive sample of 529 primary care patients. Measurements. Depression screening tool (a 9-item patient health questionnaire [PHQ-9]) and questionnaire including sociodemographic data, patient attitudes about depression, and acceptability of different treatments. Results. Mean age was 71.9 years (range 60–93 years), 314 (59%) female. Among the 529 participants, 93 (17.5%) had history of depression and 60 (11.3%) had PHQ-9 scores of 10 or greater. Participants believed depression is a disease for which they would use medication and counseling. Accepting medications from primary physicians was strongly associated with a past history of depression (P < 0.01) and with agreeing that depression needs treatment (P < 0.01). Counseling was not acceptable for those believing that they can control depression on their own (P < 0.01). Older patients (P < 0.001) and those with higher education levels (P < 0.01) were less likely to accept herbs or supplements as treatment options. Willingness to discuss treatments with family was associated with not using alcohol as a treatment and acceptance of all other treatment options (P < 0.001). Conclusions. Attitude that depression is a disease and the willingness to discuss depression with family may enhance treatment acceptance.

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The effects of antidepressant medication adherence as well as psychosocial and clinical factors on depression outcome among older adults

Abstract: Interventions should be directed toward improving antidepressant adherence and modifiable psychosocial variables.

Cited by 56 publications

References 47 publications

Support and Undermining in Interpersonal Relationships Are Associated with Symptom Improvement in a Trial of Antidepressant Medication

Support and Undermining in Interpersonal Relationships Are Associated with Symptom Improvement in a Trial of Antidepressant Medication

Six-Month Utilization of Psychotherapy by Older Adults with Depressive Symptoms

Predictors of Treatments Acceptable to Patients for Late‐Life Depression

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