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Healthcare use for major depressive disorders among middle-aged and older adults in the community

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Abstract

Purpose

There is a substantial gap between people having a mental disorder and those treated for this disorder. Studies that assessed the influence of age on healthcare use for major depressive disorder (MDD) have provided inconsistent results. We aimed to assess healthcare use in terms of treatment-seeking and psychotropic medication use in four age groups of 45- to 85-year-old community dwellers meeting criteria for MDD.

Methods

Data stemmed from CoLaus|PsyCoLaus, a population-based prospective cohort study. Diagnostic information on mental disorders, utilization of professional healthcare and psychotropic drugs was elicited using a semi-structured interview. Associations between age groups and healthcare use were established using logistic regression models with serial adjustments for socio-demographic and depression characteristics as well as comorbid mental disorders and cardio-metabolic features.

Results

Compared to participants of the youngest age group (ages 45 to 54 years), (1) those older than 75 years were less likely to use healthcare from psychiatrists or psychologists (OR: 0.4 [95% CI 0.17–0.96]), although the frequency of using any professional health care did not vary across age groups; (2) those older than 55 years used any psychotropic medication more frequently; and (3) those aged 55–64 years used antidepressants more frequently (OR: 1.61 [95% CI 1.07–2.44]), whereas those aged 65–74 years used anxiolytics more frequently (OR: 2.30 [95% CI 1.15–4.58]).

Conclusion

Age is a complex biological and social factor that influences healthcare use.

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Data availability

Data are available on request.

Code availability

Software applications and custom codes are available on request.

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Acknowledgements

The authors express their gratitude to the Lausanne inhabitants who volunteered to participate in the CoLaus|PsyCoLaus study and to all the collaborators who contributed to the coordination of the study and the collection of data.

Funding

The CoLaus|PsyCoLaus study was and is supported by research grants from GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, and the Swiss National Science Foundation (grants 3200B0–105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468; 33CS30-148401 and 33CS30_177535).

Author information

Authors and Affiliations

  1. Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Prilly, Switzerland

    Jean-Pierre Schuster & Armin von Gunten

  2. Centre for Research in Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

    Marie-Pierre F. Strippoli, Caroline L. Vandeleur & Martin Preisig

  3. Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France

    Nicolas Hoertel & Frédéric Limosin

  4. Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France

    Nicolas Hoertel & Frédéric Limosin

  5. Centre Psychiatrie Et Neurosciences, Inserm Umr 894, Paris, France

    Nicolas Hoertel & Frédéric Limosin

  6. Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Pedro Marques-Vidal

Authors
  1. Jean-Pierre Schuster
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  2. Marie-Pierre F. Strippoli
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  3. Nicolas Hoertel
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  4. Pedro Marques-Vidal
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  5. Caroline L. Vandeleur
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  6. Frédéric Limosin
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  7. Martin Preisig
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  8. Armin von Gunten
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Contributions

JPS: design, analysis, literature search, manuscript drafting. MPFS: design, analysis, figures, statistical analysis and data visualization, manuscript drafting and review. NH: design, literature search, analysis, manuscript drafting and review. PMV, CLV, FL: analysis, manuscript drafting and review. MP: design, analysis, funding acquisition, manuscript drafting and review. AvG: design, analysis, manuscript drafting and review. All authors approved the final manuscript.

Corresponding author

Correspondence to Jean-Pierre Schuster.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The institutional Ethics Committee of the University of Lausanne, which afterwards became the Ethics Commission of Canton Vaud (www.cer-vd.ch) approved the baseline CoLaus|PsyColaus study (reference 16/03). The approval was renewed for the first (reference 33/09) and the second (reference 26/14) follow-ups. The study was performed in agreement with the Helsinki declaration and its former amendments, and in accordance with the applicable Swiss legislation.

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All participants signed a written informed consent, prior to their inclusion in the study.

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Patients signed informed consent regarding publishing their data, provided that individuals could not be identified as a subject.

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Schuster, JP., Strippoli, MP.F., Hoertel, N. et al. Healthcare use for major depressive disorders among middle-aged and older adults in the community. Soc Psychiatry Psychiatr Epidemiol 57, 953–961 (2022). https://doi.org/10.1007/s00127-021-02193-8

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  • DOI: https://doi.org/10.1007/s00127-021-02193-8

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