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Cited by 22Mental Health Treatment and AccessTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Remission in major depression: results from a geriatric primary care population

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Azar, Armin R., Chopra, Mohit P., Cho, Lydia Y., Coakley, Eugenie, Rudolph, James L.·2011·International Journal of Geriatric Psychiatry
DOI 10.1002/gps.2485PMC PMC3049170
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Abstract

Objectives: While a recent task force report recommended that remission from major depression be defined according to DSM criteria, most previous work has used depressive symptom rating scales. The current study sought to identify baseline factors associated with treatment outcome in major depression, diagnosed according to DSM‐IV criteria. Methods: Data from the Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM‐E) study were utilized. This analysis focused on 792 geriatric primary care patients with major depression at baseline, which was randomized to services by a mental health professional in primary care or specialty settings. Major depression was diagnosed according to DSM‐IV criteria based on a structured interview at baseline and 6 months. The primary outcome was the absence of any DSM‐IV depressive disorder at six‐month follow‐up. Association with baseline demographic characteristics, comorbid anxiety disorder, ‘at risk’ drinking, number of co‐occurring medical conditions, and depressive symptom severity was examined using multiple logistic regression modeling. Results: Remission occurred in 228 (29%) patients with completed follow‐up assessments, while 564 (71%) did not remit. Factors which increased the odds of non‐remission included comorbid anxiety (OR = 1.60, 95% CI 1.11–2.31), female sex (OR = 1.49, 95% CI 1.04–2.15), general medical comorbidity (OR = 1.15, 95% CI 1.07–1.24), and increased baseline depressive symptom severity (OR = 1.04, 95% CI 1.03–1.06). Conclusions: The findings underscore the importance of using DSM criteria to define remission from major depression, and suggest that concurrent measurement of depression severity, comorbid anxiety, and medical comorbidity are important in identifying patients requiring targeted interventions to optimize remission from major depression. Copyright © 2010 John Wiley & Sons, Ltd.

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  • Older persons more frequently fail multiple monoamine-based antidepressant treatments, suggesting that TRD is more common in older adults.

    “It is established that older persons more frequently fail multiple monoamine-based antidepressant treatments, which may be taken as evidence that TRD is more com­ mon in this subpopulation 109, 110 .”

    From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [109]

    The Conclusion’s Key Points report that 71% of older primary-care patients with major depression had not remitted after six months of mental health treatment. But the Methods describe treatment as including both individual therapy and pharmacotherapy; the paper does not establish failures of multiple monoamine-based antidepressants or compare failure rates with younger adults. Its non-remission finding therefore supports only the broader point that treatment outcomes can be poor in this older population, not the claim about greater prevalence of treatment-resistant depression. (LLM, conf=0.87)

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  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 2000 4th Ed. Washington American Psychiatric Press (DSM-IV-TR)

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Authors
Azar, A. R., Chopra, M. P., Cho, L. Y., Coakley, E., & Rudolph, J. L.
Affiliations
  • Brigham and Women's Hospital (US)
  • Boston University (US)
  • John Snow (United States) (US)
Corresponding author
Rudolph, James L.
ORCID
Venue
International Journal of Geriatric Psychiatry
Publisher
Wiley
Published
2010-12-14
Volume
26
Issue
1
Pages
48-55
ISSN
  • 0885-6230 (ISSN-L)
  • 1099-1166
DOI
10.1002/gps.2485
PMC
PMC3049170
OpenAlex
W2050983682
Cited by
22
References
32
Citations by year
2025: 2 · 2024: 3 · 2023: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2017: 3 · 2016: 2 · 2015: 1 · 2014: 1 · 2012: 2
FWCI
2.18
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • International Journal of Geriatric Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • Centers for Medicare and Medicaid Services
  • National Institute on Aging (R03AG029861, 5-R03-AG029861-02)
  • Center for Substance Abuse Treatment
  • Center for Mental Health Services
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
major depressive disorder, remission, geriatric primary care, older adults, DSM-IV diagnostic criteria, anxiety comorbidity, comorbidities, depression severity, treatment outcome predictors
MeSH terms
Aged, Anxiety, Major Depressive Disorder, Female, Humans, Male, Mental Health Services, Remission Induction, Risk Factors, Severity of Illness Index, Sex Factors, Comorbidity, Logistic Models, Outcome Assessment, Health Care, Substance-Related Disorders, Diagnostic and Statistical Manual of Mental Disorders

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