Institut National de la Santé et de la Recherche Médicale (INSERM) U888, University of Montpellier, France
INSERM U888, Montpellier, France and Kings College London, Institute of Psychiatry, London, UK
INSERM U888, University of Montpellier
INSERM U593, University of Bordeaux
INSERM U708, University of Paris
INSERM U888, University of Montpellier, France
Correspondence: Dr Marie-Laure Ancelin, INSERM U888, Nervous System Pathologies, Hôpital La Colombière, P42, 34093 Montpellier Cedex 5, France. Email: ancelin{at}montp.inserm.fr
Background
Depression may increase the risk of mortality among certain subgroups of older people, but the part played by antidepressants in this association has not been thoroughly explored.
Aims
To identify the characteristics of older populations who are most at risk of dying, as a function of depressive symptoms, gender and antidepressant use.
Method
Adjusted Cox proportional hazards models were used to determine the association between depression and/or antidepressant use and 4-year survival of 7363 community-dwelling elderly people. Major depressive disorder was evaluated using a standardised psychiatric examination based on DSM–IV criteria and depressive symptoms were assessed using the Center for Epidemiological Studies–Depression scale.
Results
Depressed men using antidepressants had the greatest risk of dying, with increasing depression severity corresponding to a higher hazard risk. Among women, only severe depression in the absence of treatment was significantly associated with mortality.
Conclusions
The association between depression and mortality is gender-dependent and varies according to symptom load and antidepressant use.
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