The British Journal of Psychiatry (2008) 192: 12-18. doi: 10.1192/bjp.bp.107.039164
© 2008 The Royal College of Psychiatrists
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Late-life depression and mortality: influence of gender and antidepressant use

Joanne Ryan, MSc, Isabelle Carriere, PhD and Karen Ritchie, PhD

Institut National de la Santé et de la Recherche Médicale (INSERM) U888, University of Montpellier, France

Robert Stewart, MD, PhD

INSERM U888, Montpellier, France and King’s College London, Institute of Psychiatry, London, UK

Gwladys Toulemonde, MSc

INSERM U888, University of Montpellier

Jean-François Dartigues, MD, PhD

INSERM U593, University of Bordeaux

Christophe Tzourio, MD, PhD

INSERM U708, University of Paris

Marie-Laure Ancelin, PhD

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

Declaration of interest

None.

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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