Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-05T08:38:33.613Z Has data issue: false hasContentIssue false

Treatment, outcome and predictors of response in elderly depressed in-patients

Published online by Cambridge University Press:  03 January 2018

T. J. Heeren*
Affiliation:
University Hospital of Utrecht, The Netherlands
P. Derksen
Affiliation:
Department of Geriatric Psychiatry of Zon en Schild, Amersfoort
B. F. V. Heycop Ten Ham
Affiliation:
Department of Geriatric Psychiatry of Bloemendaal, The Hague, Netherlands
P. P. J. Van Gent
Affiliation:
Department of Geriatric Psychiatry of Bloemendaal, The Hague, Netherlands
*
Professor T.J. Heeren, University Hospital of Utrecht, Division of Geriatric Psychiatry of the HC Rümke Group, Oude Arnhemseweg 260, 3705 BK Zeist. The Netherlands

Abstract

Background

Full recovery rates in naturalistic studies of the treatment of elderly depressives are invariably lower than in clinical trials. This may be the result of inadequate treatment due to the lack of clear treatment strategy recommendations for the elderly.

Method

This is a naturalistic prospective study of depressed elderly in-patients in three Dutch psychiatric hospitals. Patients were included when they suffered from any mood disorder according to DSM - III - R criteria. Severity of the depression was measured on the Montgomery -Asberg Rating Scale.

Results

Antidepressants were prescribed to more than 90% of the patients. More than half of them received only one treatment. The dose of the antidepressants was less than the recommended dose for adults in 55% of cases. Full recovery from the depressive episode was achieved in less than half of the patients (33–45%).

Conclusions

In the present study a relatively poor outcome of the antidepressant treatment of elderly depressives has been found. A combination of low treatment expectations and fear of vigorous treatment seems to have been important.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Baldwin, R.C. & Jolley, D. J. (1986) The prognosis of depression in old age. British journal of Psychiatry, 149, 574583.CrossRefGoogle ScholarPubMed
Bonner, D. & Howard, R. (1995) Treatment resistant depression in the elderly (editorial). International Journal of Geriatric Psychiatry, 10, 259264.Google Scholar
Cole, M. G. (1983) Age, age of onset and course of primary depressive illness in the elderly. Canadian journal of Psychiatry, 28, 102104.Google Scholar
Foistein, M. F., Foistein, S. E. & McHugh, P R. (1975) Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 6, 189198.Google Scholar
Meats, P. Timol, M. & Jolley, D. (1991) Prognosis of depression in the elderly. British journal of Psychiatry 159, 659663.CrossRefGoogle ScholarPubMed
Meijer, M., Stege, G., van der Heeren, T. J., et al (1992) The course of clinically treated depression in the elderly (in Dutch). Nederlands Tijdschrift voor Geneeskunde, 136, 20672071.Google Scholar
Montgomery, S. A. & Ásberg, M. (1979) A new depression scale designed to be sensitive to change. British journal of Psychiatry, 134, 382389.CrossRefGoogle ScholarPubMed
Reynolds, C. F. III, Frank, E., Perel, J. M., et al (1992) Combined pharmacotherapy and psychotherapy in the acute and continuation treatment of elderly patients with recurrent major depression: a preliminary report. American journal of Psychiatry, 149, 16871692.Google Scholar
Rubin, E. H., Kinscherf, D. A. & Wehrman, S. A. (1991) Response to treatment of depression in the old and very old. journal of Geriatric Psychiatry and Neurology, 4, 6570.Google Scholar
Schneider, L. S., Reynolds, C. F. III, Labowitz, B. D., et al (1994) Diagnosis and Treatment of Depression in Late Life. Results of the NIH Consensus Development Conference. Washington, DC: American Psychiatric Press.Google Scholar
Stata, (1988) STATA 2.1 (3rd edn). Los Angeles: Computing Resource Center.Google Scholar
Zubenko, G. S., Mulsant, B. H., Rifal, A. H., et al (1994) Impact of acute psychiatric treatment on major depression in late life and prediction of response. American journal of Psychiatry, 151, 987994.Google ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.