| Autor: |
Akincigil, Ayse, Olfson, Mark, Walkup, James T., Siegel, Michele J., Kalay, Ece, Amin, Shahla, Zurlo, Karen A., Crystal, Stephen |
| Předmět: |
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| Zdroj: |
Journal of the American Geriatrics Society; Jun2011, Vol. 59 Issue 6, p1042-1051, 10p, 5 Charts |
| Abstrakt: |
To examine evolving patterns of depression diagnosis and treatment in older U.S. adults in the era of newer-generation antidepressants. Trend analysis using data from the Medicare Current Beneficiary Survey, a nationally representative survey of Medicare enrollees, from 1992 to 2005. Community, usual care. Older Medicare fee-for-service beneficiaries. Depression diagnoses and psychotherapy use identified from Medicare claims; antidepressant use identified from detailed medication inventories conducted by interviewers. The proportion of older adults who received a depression diagnosis doubled, from 3.2% to 6.3%, with rates increasing substantially across all demographic subgroups. Of those diagnosed, the proportion receiving antidepressants increased from 53.7% to 67.1%, whereas the proportion receiving psychotherapy declined from 26.1% to 14.8%. Adjusting for other characteristics, odds of antidepressant treatment in older adults diagnosed with depression were 86% greater for women, 53% greater for men, 89% greater for whites, 13% greater for African Americans, 84% greater for metropolitan-area residents, and 55% greater for nonmetropolitan-area residents. Odds of antidepressant treatment were 54% greater for those diagnosed with major depressive disorder (MDD) and 83% greater for those with other depression diagnoses, whereas the odds of receiving psychotherapy was 29% lower in those with MDD diagnoses and 74% lower in those with other depression diagnoses. Overall diagnosis and treatment rates increased over time. Antidepressants are assuming a more-prominent and psychotherapy a less-prominent role. These shifts are most pronounced in groups with less-severe depression, in whom evidence of efficacy of treatment with antidepressants alone is less clear. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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