TitleSubjective health measures and acute treatment outcomes in geriatric depression.
Publication TypeJournal Article
Year of Publication2001
AuthorsLenze, EJ, Miller, MD, Dew, MA, Martire, LM, Mulsant, BH, Begley, AE, Schulz, R, Frank, E, Reynolds, CF
JournalInt J Geriatr Psychiatry
Date Published2001 Dec
KeywordsActivities of Daily Living, Aged, Attitude to Health, Combined Modality Therapy, Depressive Disorder, Major, Female, Follow-Up Studies, Geriatric Assessment, Humans, Male, Middle Aged, Nortriptyline, Personality Inventory, Psychotherapy, Self-Assessment, Treatment Outcome

<p><b>BACKGROUND: </b>Prior research suggests that elderly patients are less likely to respond to antidepressant treatment if they have low self-rated health. However, successful treatment for depression has been associated with improvement in self-rated health and other health measures.</p><p><b>OBJECTIVES: </b>To examine measures of self-rated health, physical disability, and social function as predictors of treatment response in late-life depression, and to assess these same health measures as treatment outcomes. We hypothesized that greater impairment in these measures would predict poorer treatment response, and that these measures would show significant improvements with recovery from depression.</p><p><b>METHOD: </b>Subjects were enrolled in a depression intervention study for people aged 60 and older with recurrent unipolar major depression; they were assessed with measures of self-rated health, physical disability, and social functioning at baseline and at the end of treatment. Baseline measures were compared between the 88 remitters, 11 non-remitters, and seven dropouts. Additionally, changes in the measures were examined in subjects who recovered from the index depressive episode.</p><p><b>RESULTS: </b>Subjects with poorer self-rated health at baseline were more likely both to drop out of treatment and to not respond to adequate treatment. This relationship was independent of demographic measures, severity of depression, physical and social functioning, medical illness, personality, hopelessness, overall medication use, and side effects or non-compliance with treatment.</p><p><b>CONCLUSION: </b>Although this finding is preliminary because of the small number of dropouts and non-remitters, it suggests that lower self-rated health may independently predict premature discontinuation of treatment for depression. Additionally, subjects who recovered from depression showed significant improvements in self-rated health, physical disability, and social functioning.</p>

Alternate JournalInt J Geriatr Psychiatry
PubMed ID11748774
Grant ListK01 MH01683 / MH / NIMH NIH HHS / United States
K05 MH00295 / MH / NIMH NIH HHS / United States
P30 MH52247 / MH / NIMH NIH HHS / United States
R01 MH37869 / MH / NIMH NIH HHS / United States
T32 MH19986 / MH / NIMH NIH HHS / United States