The British Journal of Psychiatry 170: 436-440 (1997)
© 1997 The Royal College of Psychiatrists
Treatment, outcome and predictors of response in elderly depressed in- patients
TJ Heeren, P Derksen, BF van Heycop Ten Ham and PP van Gent
University Hospital of Utrecht, The Netherlands.
BACKGROUND: Full recovery rates in naturalistic studies of the treatment of
elderly depressives are invariably lower than in clinical trials. This may
be the result of inadequate treatment due to lack of clear treatment
strategy recommendations for the elderly. METHOD: This is a naturalistic
prospective study of depressed elderly in-patients in three Dutch
psychiatric hospitals. Patients were included when they suffered from any
mood disorder according to DSM-III-R criteria. Severity of the depression
was measured on the Montgomery-Asberg Rating Scale. RESULTS:
Antidepressants were prescribed to more than 90% of the patients. More than
half of them received only one treatment. The dose of the antidepressants
was less than the recommended dose for adults in 55% of cases. Full
recovery from the depressive episode was achieved in less than half of the
patients (33-45%). CONCLUSIONS: In the present study a relatively poor
outcome of the antidepressant treatment of elderly depressives has been
found. A combination of low treatment expectations and fear of vigorous
treatment seems to have been important.