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Cited by 183Suicide and Self-Harm StudiesMental Health Treatment and AccessTreatment of Major Depression

Reducing suicidal ideation in depressed older primary care patients

Unützer, Jürgen, Tang, Lingqi, Oishi, Sabine, Katon, Wayne, Williams, John W., Hunkeler, Enid, Hendrie, Hugh, Lin, Elizabeth H.B. +6 more·2006·Journal of the American Geriatrics Society
DOI 10.1111/j.1532-5415.2006.00882.x
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Abstract

OBJECTIVES: To determine the effect of a primary care–based collaborative care program for depression on suicidal ideation in older adults. DESIGN: Randomized, controlled trial. SETTING: Eighteen diverse primary care clinics. PARTICIPANTS: One thousand eight hundred one adults aged 60 and older with major depression or dysthymia. INTERVENTION: Participants randomized to collaborative care had access to a depression care manager who supported antidepressant medication management prescribed by their primary care physician and offered a course of Problem Solving Treatment in Primary Care for 12 months. Participants in the control arm received care as usual. MEASUREMENTS: Participants had independent assessments of depression and suicidal ideation at baseline and 3, 6, 12, 18, and 24 months. Depression was assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (SCID). Suicidal ideation was determined using the SCID and the Hopkins Symptoms Checklist. RESULTS: At baseline, 139 (15.3%) intervention subjects and 119 (13.3%) controls reported thoughts of suicide. Intervention subjects had significantly lower rates of suicidal ideation than controls at 6 months (7.5% vs 12.1%) and 12 months (9.8% vs 15.5%) and even after intervention resources were no longer available at 18 months (8.0% vs 13.3%) and 24 months (10.1% vs 13.9%). There were no completed suicides in either group. Information on suicide attempts or hospitalization for suicidal ideation was not available. CONCLUSION: Primary care–based collaborative care programs for depression represent one strategy to reduce suicidal ideation and potentially the risk of suicide in older primary care patients.

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Crossref · 10.1111/j.1532-5415.2006.00882.x

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  • Collaborative care models for depression have been shown to reduce suicide ideation among older adults in the U.S.

    “Collaborative care models (CCM) for depression which involve augmenting depression treatment in primary care with expert mental health consultation and medication recommendations, psychoeducation for patients, and the option of brief psychotherapy have been shown to reduce suicide ideation among older adults in the U.S. [14,15].”

    From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [15]

  • Neither trial could assess the effectiveness of the intervention on suicidal behavior because of sample size limitations.

    “Due to sample size limitations, neither trial could assess the effectiveness of the intervention on suicidal behavior, however”

    From Suicide in older adults (2011) · cites this paper as [64]

  • Two randomized trials found significantly greater reductions in depressive symptoms and suicidal ideation among depressed older primary care patients who received collaborative stepped-care interventions compared with care-as-usual.

    “both studies found significantly greater reductions in depressive symptoms and suicidal ideation in depressed older adults who received the experimental interventions (63, 64).”

    From Suicide in older adults (2011) · cites this paper as [64]

  • Research in older adults shows that collaborative care models can markedly lower suicidal ideation and depressive symptoms.

    “Although no studies have evaluated the effectiveness of CCM on suicidal behaviors in pediatric populations, research on older adults has shown that CCMs can significantly reduce suicidal ideation and symptoms of depression.105,106”

    From Evidence-based youth suicide prevention and intervention in pediatric primary care settings. (2024) · cites this paper as [105]

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Authors
Unützer, J., Tang, L., Oishi, S., Katon, W., Williams, J. W., Hunkeler, E., Hendrie, H., Lin, E. H. B., Levine, S., Grypma, L., Steffens, D. C., Fields, J., Langston, C., & for the IMPACT Investigators
Affiliations
  • University of Washington (US)
  • University of California, Los Angeles (US)
  • Duke University (US)
  • Kaiser Permanente (US)
  • Indiana University Indianapolis (US)
  • Group Health Cooperative (US)
  • The University of Texas Southwestern Medical Center (US)
  • Atlantic Philanthropies (US)
ORCID
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
2006-09-08
Volume
54
Issue
10
Pages
1550-1556
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
DOI
10.1111/j.1532-5415.2006.00882.x
OpenAlex
W2159858184
Cited by
183
References
21
Citations by year
2025: 4 · 2024: 5 · 2023: 2 · 2022: 7 · 2021: 5 · 2020: 5 · 2019: 9 · 2018: 7 · 2017: 10 · 2016: 15 · 2015: 9 · 2014: 21 · 2013: 17 · 2012: 16
FWCI
9.59
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
Funders
University of California, Los Angeles
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
suicidal ideation, depression, older adults, primary care, collaborative care, problem-solving therapy, dysthymia, suicide prevention
MeSH terms
Suicide Prevention, Aged, Attitude to Death, Cooperative Behavior, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Primary Health Care, Psychological Techniques, Suicide, Time Factors, United States

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