Older patients
with major depression live longer with
appropriate treatment
Newswise — Older patients with major depression
whose primary care physicians team with
depression care managers are 45% less likely to
die within a 5-year time period than older
adults with major depression who receive their
care in primary care practices where there are
no depression care managers. This study,
conducted by researchers at the University of
Pennsylvania School of Medicine, appears in the
current issue of the Annals of Internal
Medicine.
“The results of this study reveal the need for
engaging primary care practices as partners in
developing mental health services for older
patients,” says Joseph Gallo, MD, MPH, Associate
Professor of Family Medicine and Community
Health at Penn, and lead author of the paper.
The practice-based, randomized, controlled trial
was conducted in 20 primary care practices in
New York and Pennsylvania. 1,226 randomly
sampled patients 60-75 years of age were
screened for depression and were classified as
having major depression (396), minor depression
(203), or no depression (627).
The practices were randomly assigned to
usual care, or a depression care management
intervention, which involved a depression
care manager who worked with the primary
care provider to recommend treatment for
depression according to standard guidelines.
Patients were followed for two years, and
approximately 3 years after the study, death
certificates were reviewed to see whether
the depression intervention had any effect
on mortality.
At follow-up, 223 patients had died. Patients
with depression in intervention practices were
less likely to have died than those in usual
care practices, and risk of death was reduced in
patients with major depression, but not in
patients with minor depression, or among
patients without depression. The benefit seemed
to be almost entirely attributable to a
reduction in deaths due to cancer, and the
authors note that the mechanism for the effect
is unclear and warrants further investigation.
This study was funded by the National Institute
of Mental Health.
PENN Medicine is a $2.9 billion enterprise
dedicated to the related missions of medical
education, biomedical research, and high-quality
patient care. PENN Medicine consists of the
University of Pennsylvania School of Medicine
(founded in 1765 as the nation's first medical
school) and the University of Pennsylvania
Health System.
Penn's School of Medicine is ranked #2 in the
nation for receipt of NIH research funds; and
ranked #3 in the nation in U.S. News & World
Report's most recent ranking of top
research-oriented medical schools. Supporting
1,400 fulltime faculty and 700 students, the
School of Medicine is recognized worldwide for
its superior education and training of the next
generation of physician-scientists and leaders
of academic medicine.
The University of Pennsylvania Health System
includes three hospitals, all of which have
received numerous national patient-care honors
[Hospital of the University of Pennsylvania;
Pennsylvania Hospital, the nation's first
hospital; and Penn Presbyterian Medical Center];
a faculty practice plan; a primary-care provider
network; two multispecialty satellite
facilities; and home care and hospice.
