Pharmacologic treatment of depression in nursing home residents: a mental health services perspective.
Over the past 10 to 15 years, there has been marked progress in clinical research on depression in nursing home residents. There have also been significant changes in federal regulations designed to improve the quality of care. In 1987, only 10% of nursing home residents diagnosed with depression were receiving treatment, but by 1999,25% of all residents were receiving antidepressants. We report on two studies: one demonstrating that treatment for depression has a substantial, ecologically relevant impact in the nursing home and another demonstrating that profound changes have occurred in the clinical epidemiology of depression and its treatment in the nursing home. Although the numbers of nursing home residents receiving antidepressants have increased dramatically, there are now second-generation problems that must be addressed to ensure the delivery of effective treatment. Developing models to ensure quality of care will require focused mental health services research.
Datto
Catherine J
CJ
Department of Psychiatry, University of Pennsylvania, and the Philadelphia VA Medical Center, 19104, USA.
Oslin
David W
DW
Streim
Joel E
JE
Scheinthal
Stephen M
SM
DiFilippo
Suzanne
S
Katz
Ira R
IR
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003695:Delivery of Health Care / Q000592:standards; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D009661:Nortriptyline / Q000627:therapeutic use*; D009735:Nursing Homes; D012720:Severity of Illness Index
D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D009661:Nortriptyline