title: Treatment outcome in suicidal vs. non-suicidal elderly patients.
abstract: The authors investigated treatment outcome in elderly suicidal and non-suicidal patients with recurrent major depression. Patients without suicidal ideation in the current episode (Non-Ideators; n=150) were compared with 30 patients who expressed suicidal ideation (Ideators). Patients received combined pharmacotherapy and psychotherapy during acute and continuation treatment. Ideators had higher numbers of lifetime suicide attempts and reported significantly higher levels of depression, anxiety, and hopelessness before starting treatment. Ideators and Non-Ideators had almost identical remission rates (77% vs. 78%), but Ideators had higher relapse rates during continuation treatment (26% vs. 13%) and were more likely to receive augmentation pharmacotherapy. Anxiety and use of adjunctive medication, but not suicidal ideation, were negatively related to both remission and relapse. Our data suggest that elderly suicidal patients have an overall favorable treatment outcome. However, treatment response may be more brittle and may require the continuing use of adjunctive medications to prevent early relapse.
authors.affiliation: Intervention Research Center for the Study of Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Szanto
authors.forename: B H
authors.initials: BH
authors.lastname: Mulsant
authors.forename: P R
authors.initials: PR
authors.lastname: Houck
authors.forename: M D
authors.initials: MD
authors.lastname: Miller
authors.forename: S
authors.initials: S
authors.lastname: Mazumdar
authors.forename: C F
authors.initials: CF
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009661:Nortriptyline / Q000627:therapeutic use*; D012008:Recurrence; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D009661:Nortriptyline