title: Depressed older adults may be less cared for than depressed younger ones.
abstract: The aim of the study was to investigate depression treatment use, either psychotherapy (PT) or antidepressant drugs (ADT) in the older and younger depressed population. Cohorts of 6316 elderly (≥65 year-old) and 25,264 matched non-elderly (25-64 year-old) depressed patients were created from a large national claims database of managed care plans from 2003 to 2006. Factors associated with ADT or PT were assessed using multivariate logistic models. During the 120 days following the depression diagnosis, the elderly persons were less often treated than the younger adults either by ADT (25.6% vs. 33.8%) or by PT (13.0% vs. 34.4%). ADT dispensing occurred later in the elderly group (51 vs. 14 days). ADT was associated with comorbid chronic conditions or polypharmacy in the elderly and younger adults. The selection of treatment (ADT or PT) was associated with the history of treated depression using the same type of treatment, in both groups. Thus, depression goes commonly untreated. Comorbidity was associated with higher ADT dispensing rates. However, although depressed elderly commonly presented with comorbidity, this age group was at higher risk of untreated illness or later treatment.
authors.affiliation: Université Claude Bernard Lyon I, Villeurbanne, France; Lundbeck SAS, Global Outcomes Research Division, Issy-les-Moulineaux, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Sanglier
authors.affiliation: Lundbeck SAS, Global Outcomes Research Division, Issy-les-Moulineaux, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Saragoussi
authors.affiliation: Lundbeck SAS, Global Outcomes Research Division, Issy-les-Moulineaux, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Milea
authors.affiliation: Université de Bordeaux, U657, F-33000 Bordeaux, France; INSERM, U657, F-33000 Bordeaux, France; Centre Hospitalier Charles Perrens, F-33000 Bordeaux, France. Electronic address: mtournier@ch-perrens.fr.
authors.forename: Marie
authors.initials: M
authors.lastname: Tournier
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data; D008875:Middle Aged; D019338:Polypharmacy; D011613:Psychotherapy / Q000706:statistics & numerical data*
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressant; Depression; Old age; Psychotherapy