Science Daily — Older patients with major depression whose primary
care physicians team with depression care managers are 45% less likely
to die within a 5-year time period than older adults with major
depression who receive their care in primary care practices where
there are no depression care managers. This study, conducted by
researchers at the University of Pennsylvania School of Medicine,
appears in the current issue of the Annals of Internal Medicine.
"The results of this study reveal the need for engaging primary care
practices as partners in developing mental health services for older
patients," says Joseph Gallo, MD, MPH, Associate Professor of Family
Medicine and Community Health at Penn, and lead author of the paper.
The practice-based, randomized, controlled trial was conducted in 20
primary care practices in New York and Pennsylvania. 1,226 randomly
sampled patients 60-75 years of age were screened for depression and
were classified as having major depression (396), minor depression
(203), or no depression (627). The practices were randomly assigned to
usual care, or a depression care management intervention, which
involved a depression care manager who worked with the primary care
provider to recommend treatment for depression according to standard
guidelines. Patients were followed for two years, and approximately 3
years after the study, death certificates were reviewed to see whether
the depression intervention had any effect on mortality.
At follow-up, 223 patients had died. Patients with depression in
intervention practices were less likely to have died than those in
usual care practices, and risk of death was reduced in patients with
major depression, but not in patients with minor depression, or among
patients without depression. The benefit seemed to be almost entirely
attributable to a reduction in deaths due to cancer, and the authors
note that the mechanism for the effect is unclear and warrants further
investigation.
This study was funded by the National Institute of Mental Health.
Note: This story has been adapted from a news release issued by
University of Pennsylvania School of Medicine.
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