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Cross-National Comparisons of Antidepressant Use Among Institutionalized Older Persons Based on the Minimum Data Set (MDS)

Published online by Cambridge University Press:  29 November 2010

John P. Hirdes ,
Naoki Ikegami ,
Pálmi V. Jónsson ,
Eva Topinková ,
Colleen J. Maxwell  and
Keita Yamauchi
John P. Hirdes
Affiliation:
University of Waterloo and Providence Centre
Naoki Ikegami
Affiliation:
Keio University
Pálmi V. Jónsson
Affiliation:
University of Iceland
Eva Topinková
Affiliation:
Charles University, Czech Republic
Colleen J. Maxwell
Affiliation:
University of Calgary
Keita Yamauchi
Affiliation:
Keio University, Japan
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Abstract

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Antidepressant use was examined with samples from long-term care facilities in Toronto (Canada), Sapporo and Naie (Japan), Reykjavik (Iceland) and Prague (Czech Republic). Only in Iceland did the majority of residents with depression receive an antidepressant. Rates of depression and antidepressant use were uniformly low in Japan, and there was a great discrepancy between diagnosed depression and behavioural signs of depression in the Czech Republic. In all countries, about half the recipients of antidepressants have no clear indication of depression present. For some countries, antidepressant use was lower among residents who were female, older and more disabled. Depression is clearly under-diagnosed in the Czech Republic, but low rates of depression in Japan are somewhat more difficult to interpret. Given the widespread consensus that depression is under-detected and under treated, these results suggest that responses to depression could be improved through instruments like the MDS.

Résumé

RÉSUMÉ

On a examiné l'usage des antidépresseurs dans des échantillons provenant d'établissements de soins de longue durée de Toronto (Canada), Sapporo et Naie (Japon), Reykjavik (Islande) et Prague (République tchéque). C'est seulement en Islande que la majorité des résidents souffrant de dépression recevaient des antidépresseurs. Le taux de dépression et l'usage des antidépresseurs sont généralement faibles au Japon. On a constaté un écart important entre le diagnostic de dépression et le comportement dépressif en République tchèque. Dans tous les pays examinés, environ la moitié des utilisateurs d'antidépresseurs ne présentent pas de symptômes évidents de dépression. Dans certains pays, l'usage des antidépresseurs était moins élevé chez les résidentes, chez les aîné(e)s plus âgés ou plus handicapés. La dépression est clairement sous-diagnostiqué en République tchèque mais les faibles taux de dépression au Japon sont plus difficiles à interpréter. Étant donné l'opinion largement répandue voulant que la dépressione passe souvent inaperçue et soit done mal soignée, les résultats de l'étude laissent entendre que l'on pourrait améliorer les mesures prises dans les cas de dépression grâce à des outils comme le MDS.

Keywords

DepressionMental HealthLong-Term CareDépressionsanté mentalesoins de longue durée
Type
Research Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , supplement S2 , Fall/Automne 2000 , pp. 18 - 37
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
Copyright © Canadian Association on Gerontology 2000

Footnotes

*

Dr. Hirdes' involvement in this project was supported through the Seniors Independence Program, Health Canada and by the Providence Centre Foundation. Dr. Topinková's work is supported under grant number IGA MZ 2084-3.

1

Department of Health Studies & Gerontology, University of Waterloo, Waterloo, ON, N2L 3G1, (hirdes@healthy.uwaterloo.ca)

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