Symptomatology of Late-Life Minor Depression Among Primary Care Patients

1990 ◽  
Vol 31 (2) ◽  
pp. 174-180 ◽  
Author(s):  
Thomas E. Oxman ◽  
James E. Barrett ◽  
Jane Barrett ◽  
Paul Gerber
Keyword(s):  
Primary Care ◽  
Late Life ◽  
Minor Depression ◽  
Primary Care Patients

scholarly journals Physical exercise for late-life major depression

2015 ◽  
Vol 207 (3) ◽  
pp. 235-242 ◽  
Author(s):  
M. Belvederi Murri ◽  
M. Amore ◽  
M. Menchetti ◽  
G. Toni ◽  
F. Neviani ◽  
...  
Keyword(s):  
Primary Care ◽  
Major Depression ◽  
Physical Exercise ◽  
Primary Outcome ◽  
Rating Scale ◽  
Late Life ◽  
Lower Intensity ◽  
Progressive Exercise ◽  
Primary Care Patients ◽  
Hamilton Rating Scale

BackgroundInterventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available.AimsTo investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression.MethodPrimary care patients (>65 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of $10 on the Hamilton Rating Scale for Depression).ResultsA total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group.ConclusionsPhysical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression.

scholarly journals Healthcare Use Among Older Primary Care Patients with Minor Depression

2014 ◽  
Vol 22 (2) ◽  
pp. 207-210 ◽  
Author(s):  
Yolonda R. Pickett ◽  
Samiran Ghosh ◽  
Anne Rohs ◽  
Gary J. Kennedy ◽  
Martha L. Bruce ◽  
...  
Keyword(s):  
Primary Care ◽  
Minor Depression ◽  
Healthcare Use ◽  
Primary Care Patients

scholarly journals Patient Beliefs Predict Response to Paroxetine Among Primary Care Patients with Dysthymia and Minor Depression

2003 ◽  
Vol 16 (1) ◽  
pp. 22-31 ◽  
Author(s):  
M. D. Sullivan ◽  
W. J. Katon ◽  
J. E. Russo ◽  
E. Frank ◽  
J. E. Barrett ◽  
...  
Keyword(s):  
Primary Care ◽  
Minor Depression ◽  
Patient Beliefs ◽  
Primary Care Patients

Minor depression in family practice: functional morbidity, co-morbidity, service utilization and outcomes

2000 ◽  
Vol 30 (6) ◽  
pp. 1377-1390 ◽  
Author(s):  
H. R. WAGNER ◽  
B. J. BURNS ◽  
W. E. BROADHEAD ◽  
K. S. H. YARNALL ◽  
A. SIGMON ◽  
...  
Keyword(s):  
Primary Care ◽  
Major Depression ◽  
Service Use ◽  
Care Facility ◽  
Control Group ◽  
Close Monitoring ◽  
Minor Depression ◽  
Primary Care Settings ◽  
Co Morbidity ◽  
Primary Care Patients

Background. Minor depression is a disabling condition commonly seen in primary care settings. Although considerable impairment is associated with minor depression, little is known about the course of the illness. Using a variety of clinical and functional measurements, this paper profiles the course of minor depression over a 1 year interval among a cohort of primary care patients.Method. Patients at a university-based primary care facility were screened for potential cases of depression and selected into three diagnostic categories: an asymptomatic control group; patients with a diagnosis of major depression; and, a third category, defined as minor depression, consisting of patients who reported between two and four symptoms of depression, but who failed to qualify for a diagnosis of major depression. Functional status, service use, and physical, social and mental health were assessed at baseline and at 3-month intervals for the ensuing year.Results. Respondents with a baseline diagnosis of minor depression exhibited marked impairment on most measures both at baseline and over the following four waves. Their responses in most respects were similar to, although not as severe as, those of respondents with a baseline diagnosis of major depression. Both groups were considerably more impaired than asymptomatic controls.Conclusions. Minor depression is a persistently disabling condition often seen in primary care settings. Although quantitatively less severe than major depression, it is qualitatively similar and requires careful assessment and close monitoring over the course of the illness.

The Recognition and Treatment of Late-Life Depression: A View from Primary Care

1996 ◽  
Vol 26 (2) ◽  
pp. 155-171 ◽  
Author(s):  
Christopher M. Callahan ◽  
Hugh C. Hendrie ◽  
William M. Tierney
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Primary Care Physicians ◽  
Late Life ◽  
Primary Care Providers ◽  
Future Research ◽  
Care Providers ◽  
Late Life Depression ◽  
Primary Care Patients

Objective: Efforts to improve the recognition and treatment of late-life depression in primary care are often based on the assumption that primary care physicians underutilize currently available and effective treatments. This article reviews the validity of this assumption and offers recommendations for future research. Methods: Clinical trials designed to improve the recognition and treatment of late-life depression in primary care are reviewed. Because studies limited to older adults are rare, we also include studies enrolling younger patients. These data are reviewed in the context of recent reviews on the prevalence of depression in primary care settings and the effectiveness of available treatments. Results: Although depressive symptoms are common among older adults, there is insufficient literature documenting the proportion of these patients who respond to currently available treatments. Patients with uncomplicated major depressive disorder constitute the minority of primary care patients with depressive symptoms. Nearly all available studies of treatment effectiveness of pharmacotherapy or psychotherapy focus on older adults with uncomplicated major depression. Currently available treatment options may apply to less than 15 percent of depressed primary care patients. Conclusions: More research is needed to help primary care providers manage their depressed patients with comorbid medical conditions, functional disability, or minor or chronic depressions. In addition, more research is needed to identify those patients who would benefit from specialized or interdisciplinary care.

scholarly journals Role of persistent and worsening sleep disturbance in depression remission and suicidal ideation among older primary care patients: the PROSPECT study

SLEEP ◽  
2020 ◽  
Vol 43 (10) ◽  
Author(s):  
Joseph J Gallo ◽  
Seungyoung Hwang ◽  
Christine Truong ◽  
Charles F Reynolds ◽  
Adam P Spira
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Suicidal Ideation ◽  
Major Depression ◽  
Sleep Disturbance ◽  
Primary Care Physicians ◽  
Minor Depression ◽  
Increased Risk ◽  
Primary Care Patients ◽  
Clinically Significant

Abstract Study Objectives We analyzed data from a practice-based randomized controlled trial within 20 primary care practices located in greater New York City, Philadelphia, and Pittsburgh to determine whether persistent or worsening sleep disturbance plays a role in the outcomes of depression and suicidal ideation at 1 year in older adults with depression. Methods The study sample consisted of 599 adults aged 60 years and older meeting criteria for major depression or clinically significant minor depression. Longitudinal analysis via growth curve mixture modeling was carried out to classify patients as having worsening, persistent, or improving sleep over 1 year. Results At 1-year follow-up, compared with patients with improving sleep, those with worsening sleep were more likely to have a diagnosis of major depression (adjusted odds ratio (aOR) = 28.60, 95% confidence interval (CI) 12.15 to 67.34), a diagnosis of clinically significant minor depression (aOR = 11.88, 95% CI 5.67 to 24.89), and suicidal ideation (aOR = 1.10, 1.005 to 1.199), and were half as likely to achieve remission (aOR = 0.52, 95% CI 0.46 to 0.57). Patients with persistent sleep disturbance showed similar but attenuated results. Conclusions Older primary care patients with depression who exhibit worsening or persistent sleep disturbance were at increased risk for persistent depression and suicidal ideation 1 year later. The pattern of sleep disturbance over time may be an important signal for exploration by primary care physicians of depression and suicidal ideation among older adults with depression. Clinical Trial Registration NCT00279682.

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