Depression and Bipolar Support Alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in late life.
OBJECTIVE
To review progress made during the past decade in late-life mood disorders and to identify areas of unmet need in health care delivery and research.


METHODS
The Consensus Development Panel consisted of experts in late-life mood disorders, geriatrics, primary care, mental health and aging policy research, and advocacy.


METHODS
(1) Literature reviews addressing risk factors, prevention, diagnosis, treatment, and delivery of services and (2) opinions and experiences of primary care and mental health care providers, policy analysts, and advocates.


METHODS
The Consensus Development Panel listened to presentations and participated in discussions. Workgroups considered the evidence and prepared preliminary statements. Workgroup leaders presented drafts for discussion by the Consensus Development Panel. The final document was reviewed and edited to incorporate input from the entire Consensus Development Panel.


CONCLUSIONS
Despite the availability of safe and efficacious treatments, mood disorders remain a significant health care issue for the elderly and are associated with disability, functional decline, diminished quality of life, mortality from comorbid medical conditions or suicide, demands on caregivers, and increased service utilization. Discriminatory coverage and reimbursement policies for mental health care are a challenge for the elderly, especially those with modest incomes, and for clinicians. Minorities are particularly underserved. Access to mental health care services for most elderly individuals is inadequate, and coordination of services is lacking. There is an immediate need for collaboration among patients, families, researchers, clinicians, governmental agencies, and third-party payers to improve diagnosis, treatment, and delivery of services for elderly persons with mood disorders.
Charney
Dennis S
DS
National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
Reynolds
Charles F
CF
Lewis
Lydia
L
Lebowitz
Barry D
BD
Sunderland
Trey
T
Alexopoulos
George S
GS
Blazer
Dan G
DG
Katz
Ira R
IR
Meyers
Barnett S
BS
Arean
Patricia A
PA
Borson
Soo
S
Brown
Charlotte
C
Bruce
Martha L
ML
Callahan
Christopher M
CM
Charlson
Mary E
ME
Conwell
Yeates
Y
Cuthbert
Bruce N
BN
Devanand
D P
DP
Gibson
Mary Jo
MJ
Gottlieb
Gary L
GL
Krishnan
K Ranga
KR
Laden
Sally K
SK
Lyketsos
Constantine G
CG
Mulsant
Benoit H
BH
Niederehe
George
G
Olin
Jason T
JT
Oslin
David W
DW
Pearson
Jane
J
Persky
Trudy
T
Pollock
Bruce G
BG
Raetzman
Susan
S
Reynolds
Mildred
M
Salzman
Carl
C
Schulz
Richard
R
Schwenk
Thomas L
TL
Scolnick
Edward
E
Unutzer
Jurgen
J
Weissman
Myrna M
MM
Young
Robert C
RC
D000367:Age Factors; D000368:Aged; D000375:Aging / Q000523:psychology; D001291:Attitude of Health Personnel; D001714:Bipolar Disorder / Q000175:diagnosis / Q000628:therapy; D015897:Comorbidity; D003695:Delivery of Health Care / Q000592:standards*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis* / Q000628:therapy*; D011320:Primary Health Care / Q000592:standards; D012106:Research; D012307:Risk Factors; D014481:United States