Skip to main content Accessibility help
×
Home

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

  • T. J. Heeren (a1), P. Derksen (a2), B. F. V. Heycop Ten Ham (a3) and P. P. J. Van Gent (a3)

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.

Copyright

Corresponding author

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

References

Hide All
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM-III-R). Washington, DC: APA.
Baldwin, R.C. & Jolley, D. J. (1986) The prognosis of depression in old age. British journal of Psychiatry, 149, 574583.
Bonner, D. & Howard, R. (1995) Treatment resistant depression in the elderly (editorial). International Journal of Geriatric Psychiatry, 10, 259264.
Cole, M. G. (1983) Age, age of onset and course of primary depressive illness in the elderly. Canadian journal of Psychiatry, 28, 102104.
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.
Meats, P. Timol, M. & Jolley, D. (1991) Prognosis of depression in the elderly. British journal of Psychiatry 159, 659663.
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.
Montgomery, S. A. & Ásberg, M. (1979) A new depression scale designed to be sensitive to change. British journal of Psychiatry, 134, 382389.
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.
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.
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.
Stata, (1988) STATA 2.1 (3rd edn). Los Angeles: Computing Resource Center.
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.

Related content

Powered by UNSILO

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

  • T. J. Heeren (a1), P. Derksen (a2), B. F. V. Heycop Ten Ham (a3) and P. P. J. Van Gent (a3)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

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

  • T. J. Heeren (a1), P. Derksen (a2), B. F. V. Heycop Ten Ham (a3) and P. P. J. Van Gent (a3)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *