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Depression may increase the risk of mortality among certain subgroups of
older people, but the part played by antidepressants in this association
has not been thoroughly explored.
To identify the characteristics of older populations who are most at risk
of dying, as a function of depressive symptoms, gender and antidepressant
Adjusted Cox proportional hazards models were used to determine the
association between depression and/or antidepressant use and 4-year
survival of 7363 community-dwelling elderly people. Major depressive
disorder was evaluated using a standardised psychiatric examination based
on DSM-IV criteria and depressive symptoms were assessed using the Center
for Epidemiological Studies Depression scale.
Depressed men using antidepressants had the greatest risk of dying, with
increasing depression severity corresponding to a higher hazard risk.
Among women, only severe depression in the absence of treatment was
significantly associated with mortality.
The association between depression and mortality is gender-dependent and
varies according to symptom load and antidepressant use.
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