Treating geriatric depression in primary care
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Depression, a significant problem among older adults, is most commonly reported in the primary care setting. To offer the treatments for depression preferred by many older adults, clinical providers and researchers have called for the creation of integrative psychosocial care options in primary care, using mental health providers working in collaboration with medical providers. In this article, we examine the empirical status of integrating treatment for depression in older adults in the primary care setting by summarizing the current models of integrated care and latest research developments. We discuss the strengths and limitations of the current integration models and offer recommendations for expanding work in this important area.
- Tolliver L: Social and mental health needs of the aged. Am Psychol 1983, 38:316–318. CrossRef
- Lyness JM, Caine ED, King DA, et al.: Depressive disorders and symptoms in older primary care patients: one year outcomes. Am J Geriatr Psychiatry 2002, 10:275–282. CrossRef
- Speer DC, Schneider MG: Mental health needs of older adults and primary care: opportunity for interdisciplinary geriatric team practice. Clin Psychol Sci Prac 2003, 10:85–101. CrossRef
- Jongenelis K, Pot AM, Eisses AM, et al.: Prevalence and risk indicators of depression in elderly nursing home patients: the AGED study. J Affect Disord 2004, 83:135–142. CrossRef
- Areán PA, Alvidrez J, Barrera A, et al.: Would older medical patients use psychological services? Gerontologist 2002, 42:392–398.
- Gum AM, Areán PA, Hunkeler E, et al.: Depression treatment preferences in older primary care patients. Gerontologist 2006, 46:4–22.
- Landreville P, Landry J, Baillargeon L, et al.: Older adults’ acceptance of psychological and pharmacological treatments for depression. J Gerontol B Psychol Sci Soc Sci 2001, 56:285–291.
- Bartels SJ, Dums AR, Oxman TE, et al.: Evidence-based practices in geriatric mental health care. Psychiatr Serv 2002, 53:1419–1431. CrossRef
- Üstün TB, Aysuo-Mateos JL, Chatterji S, et al.: Global burden of depressive disorders in the year 2000. Br J Psychiatry 2004, 184:386–392. CrossRef
- Williamson GM: Pain, functional disability and depressed affect. In Physical Illness and Depression in Older Adults: A Handbook of Theory, Research and Practice. Edited by Williamson GM, Shaffer DR. New York: Plenum Publishers; 2000:51–64.
- Lyness JM, Heo M, Datto CJ, et al.: Outcomes of minor and subsyndromal depression among elderly patients in primary care settings. Ann Intern Med 2006, 144:496–504.
- Callahan CM, Hui SL, Nienaber NA, et al.: Longitudinal study of depression and health services use among elderly primary care patients. J Am Geriatr Soc 1994, 42:833–838.
- Conwell Y, Lyness JM, Duberstein P, et al.: Completed suicide among older patient in primary care practices: a controlled study. J Am Geriatr Soc 2000, 48:23–29.
- Ariyo AA, Haan M, Tangen CM, et al.: Depressive symptoms and risks of coronary heart disease and mortality in elderly Americans. Circulation 2000, 102:1773–1779.
- Freudenstein U, Jagger C, Arthur A, Donner-Banzhoff N: Treatments for late-life depression in primary care: a systematic review. Fam Pract 2001, 18:321–327. CrossRef
- Skultety KM, Zeiss AM: The treatment of depression in older adults in the primary care setting: an evidence-based review. Health Psychol 2006, 25:665–674. CrossRef
- Bruce ML, Ten Have TR, Reynolds CF, et al.: Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized control trial. JAMA 2004, 291:1081–1091. CrossRef
- Unützer J, Katon W, Callahan CM, et al.: Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA 2002, 288:2836–2845. CrossRef
- Boult C, Boult LB, Morishita L, et al.: A randomized clinical trial of outpatient geriatric evaluation and management. J Am Geriatr Soc 2001, 49:351–359. CrossRef
- Burns R, Nichols LO, Graney MJ, Cloar FT: Impact of continued geriatric outpatient management on health outcomes of older veterans. Arch Intern Med 1995, 155:1313–1318. CrossRef
- Burns R, Nichols LO, Martindale-Adams J, Graney MJ: Interdisciplinary geriatric primary care evaluation and management: two year outcomes. J Am Geriatr Soc 2000, 48:8–13.
- Toseland RW, O’Donnell JC, Engelhardt JB, et al.: Outpatient geriatric evaluation management: results of a randomized trial. Med Care 1996, 34:624–640. CrossRef
- Blanchard MR, Waterreus A, Mann AH: The effect of primary care nurse intervention upon older people screened as depressed. Int J Geriatr Psychiatry 1995, 10:289–298. CrossRef
- Mulsant BH, Alexopoulos GS, Reynolds CF 3rd, et al.: Pharmacological treatment of depression in older primary care patients: the PROSPECT algorithm. Int J Geriatr Psychiatry 2001, 16:585–592. CrossRef
- Gallo JJ, Bogner HR, Knashawn HM, et al.: The effect of a primary care practice-based depression intervention on mortality in older adults: a randomized trial. Ann Intern Med 2007, 146:689–698.
- Hunkeler EM, Katon W, Tang L, et al.: Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care. BMJ 2006, 332:259–263. CrossRef
- Unützer J, Tang L, Oishi S, et al.: Reducing suicidal ideation in depressed older primary care patients. J Am Geriatr Soc 2006, 54:1550–1556. CrossRef
- Areán PA, Ayalon L, Hunkeler E, et al.: Improving depression care for older, minority patients in primary care. Med Care 2005, 43:381–390. CrossRef
- Areán PA, Gum AM, Tang L, Unützer J: Service use and outcomes among elderly persons with low incomes being treated for depression. Psychiatr Serv 2007, 58:1057–1064. CrossRef
- Grypma L, Haverkamp R, Little S, Unützer J: Taking an evidence-based model of depression care from research to practice: making lemonade out of depression. Gen Hosp Psychiatry 2006, 28:101–107. CrossRef
- Levkoff SE, Chen H, Coakley E, et al.: Design and sample characteristics of the PRISM-E multisite randomized trial to improve behavioral health care for the elderly. J Aging Health 2004, 16:3–27. CrossRef
- Krahn DD, Bartels SJ, Caokley E, et al.: PRISM-E: comparison of integrated care and enhanced specialty referral models in depression outcomes. Psychiatr Serv 2006, 57:946–953. CrossRef
- Gallo JJ, Zubritsky C, Maxwell J, et al.: Primary care clinicians evaluate integrated and referral models of behavioral health care for older adults: results from a multisite effectiveness trial (PRISM-E). Ann Fam Med 2004, 2:305–309. CrossRef
- Chen H, Coakley EH, Cheal K, et al.: Satisfaction with mental health services in older primary care patients. Am J Geriatr Psychiatry 2006, 14:371–379. CrossRef
- van Schaik A, van Marwijk J, Adèr H, et al.: Interpersonal psychotherapy for elderly patients in primary care. Am J Geriatr Psychiatry 2006, 14:777–786. CrossRef
- Katon WJ, Von Korff M, Lin EH, et al.: The pathways study: a randomized trial of collaborative care in patients with diabetes and depression. Arch Gen Psychiatry 2004, 61:1042–1049. CrossRef
- Smit F, Willemse G, Koopmanschap M, et al.: Cost-effectiveness of preventing depression in primary care patients: randomised trial. Br J Psychiatry 2006, 188:330–336. CrossRef
- Dobscha SK, Corson K, Hickam DH, et al.: Depression decision support in primary care: a cluster randomized trial. Ann Intern Med 2006, 145:477–487.
- Gensichen J, Torge M, Peitz M, et al.: Case management for the treatment of patients with major depression in general practices—rationale, design and conduct of a cluster randomized controlled trial—PRoMPT (PRi-mary care Monitoring for depressive Patient’s Trial). [ISRCTN66386086]—study protocol. BMC Public Health 2005, 5:101–106. CrossRef
- Callahan CM, Boustani MA, Unverzagt FW, et al.: Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial. JAMA 2006, 295:2148–2157. CrossRef
- Rubenstein LZ, Alessi CA, Josephson KR, et al.: A randomized trial of screening, case finding, and referral system for older veterans in primary care. J Am Geriatr Soc 2007, 55:166–174. CrossRef
- Adams WL, McIlvain HE, Lacy NL, et al.: Primary care for elderly people: why do doctors find it so hard? Gerontologist 2002, 42:835–842.
- Jeste DV, Alexopoulos GS, Bartels SJ, et al.: Consensus statement on the upcoming crisis in geriatric mental health: research agenda for the next 2 decades. Arch Gen Psychiatry 1999, 56:848–853. CrossRef
- Williams JW, Barrett J, Oxman T, et al.: Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. JAMA 2000, 284:1519–1526. CrossRef
- Scogin F, McElreath L: Efficacy of psychosocial treatments for geriatric depression: a quantitative review. J Consult Clin Psychol 1994, 62:69–74. CrossRef
- Scogin F, Welsh D, Hanson A, et al.: Evidence-based psychotherapies for depression in older adults. Clin Psychol Sci Prac 2005, 12:222–237. CrossRef
- Treating geriatric depression in primary care
Current Psychiatry Reports
Volume 10, Issue 1 , pp 44-50
- Cover Date
- Print ISSN
- Online ISSN
- Current Science Inc.
- Additional Links