Among elderly Medicare beneficiaries, significant racial/ethnic differences exist in the diagnosis and treatment of depression. Vigorous clinical and public health initiatives are needed to address this persisting disparity in care.
Overall diagnosis and treatment rates increased over time. Antidepressants are assuming a more-prominent and psychotherapy a less-prominent role. These shifts are most pronounced in groups with less-severe depression, in whom evidence of efficacy of treatment with antidepressants alone is less clear.
In middle-aged and older Americans, unsecured debt has negative effects on mental health because of the associated depressive symptoms and decreased psychological well-being. The deleterious effects of unsecured debt on mental health are largely accounted for by perceived control over personal financial circumstances. Interventions enhancing older adults' control over personal financial circumstances may protect against the psychological decrements experienced by those grappling with unsecured debt.
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