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Depression and use of antidepressants in Swedish nursing homes: a 12-month follow-up study

Published online by Cambridge University Press:  16 December 2013

Patrik Midlöv ,
Martin Andersson ,
Carl Johan Östgren  and
Sigvard Mölstad
Patrik Midlöv*
Affiliation:
Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden
Martin Andersson
Affiliation:
Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden
Carl Johan Östgren
Affiliation:
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
Sigvard Mölstad
Affiliation:
Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden
*
Correspondence should be addressed to: Patrik Midlöv, Center for Primary Health Care Research, Lund University, Clinical Research Centre (CRC), Jan Waldenströms gata 35, Skåne University Hospital, 205 02 Malmö, Sweden, Phone: +4640 391363; Fax: +4640 391370. Email: patrik.midlov@med.lu.se.
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Abstract

Background:

The prescription of antidepressants in nursing homes has increased markedly since the introduction of SSRIs, while at the same time depressive symptoms often go unrecognized and untreated. The aim of this study was to examine whether depression among residents in nursing homes is treated adequately.

Methods:

A sample of 429 participants from 11 Swedish nursing homes was selected and was assessed with the Cornell Scale for Depression in Dementia (CSDD) and using medical records and drug prescription data. For 256 participants a follow-up assessment was performed after 12 months.

Results:

The prevalence of depression, according to medical records, was 9.1%, and the prevalence of CSDD score of ≥8 was 7.5%. Depression persisted in more than 50% of cases at the 12-month follow-up. Antidepressants were prescribed to 33% of the participants without a depression diagnosis or with a CSDD score of <8. 46.2% of all participants were prescribed antidepressants. 14% of the participants without a depression diagnosis or with a CSDD score of <8 had psychotropic polypharmacy. 15.2% of all participants had psychotropic polypharmacy, which persisted at the 12-month follow-up in three-quarters of cases.

Conclusion:

The prescription of antidepressants in frail elderly individuals is extensive and may be without clear indication. The clinical implication is that there is a need for systematic drug reviews at nursing homes, paying special attention to the subjects which are on antidepressants.

Keywords

depressionantidepressantsnursing homesSwedendementia
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 4 , April 2014 , pp. 669 - 675
Copyright
Copyright © International Psychogeriatric Association 2013 

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