Depression Treatment: Racial Differences in Adherence to Antidepressant Treatment in Later Life.

Racial Differences in Adherence to Antidepressant Treatment in Later Life.

Filed under: Depression Treatment

Am J Geriatr Psychiatry. 2012 Oct 10;
Kales HC, Nease DE, Sirey JA, Zivin K, Kim HM, Kavanagh J, Lynn S, Chiang C, Neighbors HW, Valenstein M, Blow FC

OBJECTIVE:: Although antidepressants are an effective treatment for later-life depression, older patients often choose not to initiate or to discontinue medication treatment prematurely. Although racial differences in depression treatment preferences have been reported, little is known about racial differences in antidepressant medication adherence among older patients. DESIGN:: Prospective, observational study comparing antidepressant adherence for older African American and white primary care patients. PARTICIPANTS:: A total of 188 subjects age 60 and older, diagnosed with clinically significant depression with a new recommendation for antidepressant treatment by their primary care physician. MEASUREMENT:: Study participants were assessed at study entry and at the 4-month follow-up (encompassing the acute treatment phase). Depression medication adherence was based on a well-validated self-report measure. RESULTS:: At the 4-month follow-up, 61.2% of subjects reported that they were adherent to their antidepressant medication. In unadjusted and two of the three adjusted analyses, African American subjects (n = 82) had significantly lower rates of 4-month antidepressant adherence than white subjects (n = 106). African American women had the lowest adherence rates (44.4%) followed by African American men (56.8%), white men (65.3%), and white women (73.7%). In logistic regression models controlling for demographic, illness, and functional status variables, significant differences persisted between African American women and white women in reported 4-month antidepressant adherence (OR: 3.58, 95% CI: 1.27-10.07, Wald ? = 2.42, df = 1, p <0.02). CONCLUSIONS:: The results demonstrate racial and gender differences in antidepressant adherence in older adults. Depression treatment interventions for older adults should take into account the potential impact of race and gender on adherence to prescribed medications. HubMed – depression


Positive effects of a cognitive-behavioral intervention program for family caregivers of demented elderly.

Filed under: Depression Treatment

Arq Neuropsiquiatr. 2012 Oct; 70(10): 786-92
Fialho PP, Köenig AM, Santos MD, Barbosa MT, Caramelli P

It was to examine the effects of a Cognitive-Behavioral Therapy (CBT) program administered to family caregivers of dementia patients.Forty family caregivers were enrolled in a CBT intervention across eight weekly sessions. Cognitive, functional and behavioral status of patients were evaluated, as well as their own and their family caregivers’ perceptions of quality of life. Specific instruments were also applied to evaluate caregiver stress level, coping, anxiety and depression.At the end of the program, family caregivers reported fewer neuropsychiatric symptoms among patients and an improvement in patients’ quality of life. In addition, caregivers changed their coping strategies, whereas a significant decrease was observed in their anxiety levels.The CBT program employed appears to be a promising and useful tool for clinical practice, displaying positive effects on quality of life and neuropsychiatric symptoms of dementia, as well as proving beneficial for alleviating anxiety and stress in family caregivers.
HubMed – depression


Functional impairments in white matter syndrome of neuropsychiatric systemic lupus erythematosus are similar to those observed in patients with multiple sclerosis.

Filed under: Depression Treatment

Arq Neuropsiquiatr. 2012 Oct; 70(10): 769-73
Sisterolli-Diniz D, Oliveira Ad, Paula DS, Rodrigues RV, Silva NA

In order to compare white matter syndrome of neuropsychiatric systemic lupus erythematosus (NPSLE) and multiple sclerosis (MS), an assessment on demographic, medical history, and clinical data was proposed.Sixty-four patients with NPSLE and 178 with MS answered a questionnaire and were evaluated regarding functional system, expanded disability status scale (EDSS), Beck depression inventory (BDI), and Beck anxiety inventory (BAI).The prevalence of autoimmune diseases and altered consciousness was similar in both groups, however it was higher than in the general population. Systemic signs and symptoms occurred from 2.9 to 61.9% of the MS cases, while neurological signs and symptoms occurred in 9.4 to 76.4% of the NPSLE ones. The motor, visual, and mental systems were the most affected in both diseases. The BDI in NPSLE had higher scores and the BAI in MS.The functional impairments in NPSLE were similar to those of MS, although greater impairment of the functional systems of cerebellar, sensitivity, and sphincters occurred in MS cases, and greater symptoms of depression, anxiety, and headache also occurred in it.
HubMed – depression


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