Treatment of depression in the elderly: effect of physical illness on response.
OBJECTIVE
To determine the response to treatment of different subgroups within a sample of physically ill elderly depressed patients.


METHODS
Acute geriatric medical inpatients with depression, randomly assigned to an 8-week double-blind placebo-controlled trial of fluoxetine.


METHODS
Response rate as defined by the 17-item Hamilton Depression Rating Scale.


RESULTS
Data were analysed in subgroups according to diagnosed physical problems and concomitant medication. A logistic regression analysis was performed to identify subgroups valid for separate analysis. Those reaching at least 5 weeks of treatment showed a significant improvement compared with the placebo group if they had serious life-threatening disease, cerebrovascular disease, were not demented, or were either on no analgesics or on analgesics stronger than paracetamol.


CONCLUSIONS
While the response to treatment in these subgroups was encouraging, general physicians must not be led to believe that the answer to depression lies only in pharmacological intervention, just as the belief that the risk-benefit ratio of such treatment where indicated is too high must be discouraged.
Evans
M
M
Wirral Community Healthcare NHS Trust, Liverpool, UK.
Hammond
M
M
Wilson
K
K
Lye
M
M
Copeland
J
J
D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D002908:Chronic Disease / Q000188:drug therapy / Q000523:psychology*; D003863:Depression / Q000150:complications* / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D005852:Geriatric Psychiatry / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors