Antidepressant use and depressive symptomatology among older people from the Australian Longitudinal Study of Ageing

Zhang, Ying; Chow, Veronica; Vitry, Agnès; Ryan, Philip; Roughead, Elizabeth E.; Caughey, Gillian E.; Ramsay, Emmae; Gilbert, Andrew L.; Esterman, Adrian; Luszcz, Mary A.

doi:10.1017/s1041610209991554

Cited by 27 publications

(32 citation statements)

References 38 publications

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“…Consistent with past research, 8, 9, 11 medical illnesses and somatic complaints were associated with AD use. It might be the case that associations between a physical complaints or illnesses and AD use are explained by access to primary care physicians by individuals with chronic medical conditions.…”

Section: Discussionsupporting

confidence: 86%

“…6 There is some evidence that this potential AD use without an indicated mental disorder diagnosis may be more pronounced in some population subgroups, including females, 8-11 older adults, 8, 10 whites 2 and individuals with physical health problems. 8, 9, 11 Furthermore, some of the individuals who continue to use antidepressants on a long-term basis might have met the criteria for a mental disorder in remote past. While long-term maintenance AD treatment may be indicated in some of these individuals, 12 long-term use of these medications is not always indicated.…”

Section: Introductionmentioning

confidence: 99%

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Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample

Takayanagi

Spira

Bienvenu³

et al. 2014

J. Clin. Psychiatry

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Objectives Past studies have shown that many individuals who use antidepressants do not have a current or lifetime history of mental disorders. However, recent studies suggest that the one-time retrospective evaluation of mental disorders commonly used in such studies may substantially underestimate the true lifetime prevalence of mental disorders. We examined the prevalence of mental disorders, assessed prospectively over multiple interviews, among individuals currently using antidepressants in a community sample. Methods Using data from the Baltimore Epidemiologic Catchment Area (ECA) Survey Wave 1 (1981) through Wave 4 (2004) (N = 1071), we assessed lifetime prevalence of common mood and anxiety disorders according to the DSM-III and DSM-III-R criteria, based on 4 interviews, among participants who reported current antidepressant use. Furthermore, we examined factors associated with current antidepressant use. Results Thirteen percent of participants at Wave 4 reported currently using antidepressant medications. Among antidepressant users, 69% never met criteria for major depressive disorder (MDD), and 38% never met criteria for MDD, obsessive-compulsive disorder, panic disorder, social phobia, or generalized anxiety disorder in their lifetime. Female gender, Caucasian ethnicity, recent or current physical problems (e.g., loss of bladder control, hypertension and back pain) and recent mental health facility visits were associated with antidepressant use in addition to mental disorders. Conclusions Many individuals who are prescribed and use antidepressant medications may not have met criteria for mental disorders. Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample

Takayanagi

Spira

Bienvenu³

et al. 2014

J. Clin. Psychiatry

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“…Randomized clinical trials performed on depressed older adults samples have demonstrated moderate to large effect sizes for selective serotonin re-uptake inhibitors, tricyclic antidepressants and monoamine oxidase inhibitors [21]. Nevertheless, only a small proportion of older adults with depression (around 20%) receive adequate treatment [22, 23]. Lack of treatment among older adults may reflect, in part, the difficulty of detecting depression in older adults, due to age-specific presentation of disease: compared with young adults, older patients tend to present less emotional symptoms of depression, such as sadness, worthlessness/guilt, worry, and fear, and are less accurate at identifying depressive symptoms overall [24].…”

Section: Introductionmentioning

confidence: 99%

Physical Activity in Depressed Elderly. A Systematic Review

Mura¹,

Carta²

2013

CPEMH

102

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Background:exercise may reduce depressive symptoms both in healthy aged populations and in old patients diagnosed with MDD, but few specific analysis were conducted on the efficacy of exercise as an adjunctive treatment with antidepressants, which may be probably more useful in clinical practice, considered the high prevalence of treatment resistant depression in late life, the low cost and safety of physical activity interventions. Objective: to establish the new findings on the effectiveness of exercise on depression in elderlies, with particular focus on the efficacy of the exercise as an adjunctive treatment with antidepressants drug therapy.Method:the search of significant articles was carried out in PubMed/Medline with the following key words: “exercise”, “physical activity”, “physical fitness”, “depressive disorder”, “depression”, “depressive symptoms”, “late life”, “old people”, and “elderly”. Results:44 papers were retrieved by the search. Among the 10 included randomized controlled trials, treatment allocation was adequately conceived in 4 studies, intention-to-treat analysis was performed in 6 studies, but no study had a double-blinded assessment. We examined and discussed the results of all these trials.Conclusion:in the last 20 years, few progresses were done in showing the efficacy of exercise on depression, due in part to the persistent lack of high quality research, in part to clinical issues of management of depression in late life, in part to the difficult to establish the real effectiveness of exercise on depressive symptoms in elderlies. However, there are some promising findings on physical activity combined with antidepressants in treatment resistant late life depression.

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“…The prevalence of major depression is over 14% among homecare patients (1) with no significant racial differences (2). Over the past decade, rates of antidepressant use in geriatric patients have increased substantially (3); with recently available national data on homecare patients showing that 1/3 were prescribed an antidepressant (4, 5). These data will also be used in this study to compare antidepressant use in whites and blacks.…”

Section: Introductionmentioning

confidence: 99%

Racial Differences in Antidepressant Use Among Older Home Health Care Patients

Pickett

Weissman²,

Bruce³

2012

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Objective The objective of this study is to determine the effect of race (black versus white) on depression diagnosis and antidepressant use in older Home Healthcare patients. Methods Cross-sectional data were obtained from the 2007 National Home and Hospice Care Survey of patients 65+ years (N=3,157). Participants were analyzed by race, antidepressant use, and charted depression diagnosis. Results In whites compared to blacks, there were greater odds of receiving a depression diagnosis (OR=4.06, 95% CI=1.66-9.93). There were also greater odds of receiving an antidepressant in whites both with (OR=3.08, 95% CI=0.46-20.81) and without a depression diagnosis (OR=2.43, 95% CI=1.53-3.86). Conclusion Older blacks were less likely than older whites to receive antidepressants, independent of a depression diagnosis. This suggests that older blacks in home healthcare with depression may face two sets of disparities relative to whites: underdiagnosis and undertreatment of depression.

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Antidepressant use and depressive symptomatology among older people from the Australian Longitudinal Study of Ageing

Abstract: Use of antidepressants increased, while depressive symptoms remained stable, in the ALSA over a 12-year period. Use of antidepressants was low for people with depressive symptoms.

Cited by 27 publications

References 38 publications

Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample

Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample

Physical Activity in Depressed Elderly. A Systematic Review

Racial Differences in Antidepressant Use Among Older Home Health Care Patients

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