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NEW ORLEANS — Fears and misconceptions about antidepressant medications contribute to older adults' reluctance to use pharmacologic treatment for depression, a qualitative study has shown.
“Depression is highly prevalent but undertreated in elderly primary care patients, despite the availability of effective medications,” Jane L. Givens, M.D., reported at the annual meeting of the Society of General Internal Medicine. Among the patient-level factors preventing appropriate treatment in this population are fear of addiction, concern about unnatural happiness or inability to feel grief and sadness, and fear of side effects.
Dr. Givens and her colleagues at the University of Pennsylvania in Philadelphia recruited a subsample of 68 older adults (mean age 75 years) with depression who participated in one of two qualitative, randomized treatment studies—the Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT) or the Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E). Each of the patients participated in semistructured home-based interviews, which were audiotaped, transcribed, and entered into qualitative data analysis software for coding and analysis.
“Four themes emerged from this review,” Dr. Givens said. “Many expressed a fear of needing to take antidepressants for the rest of their lives or of becoming addicted. Some did not want to be unnaturally happy or to mute their capacity to feel sadness or to 'face reality.'”
Other patients resisted treating symptoms of sadness associated with the loss of a loved one, and some had previous histories of treatment with psychiatric medications, including tranquilizers, and were concerned about the side effects, particularly sedation, Dr. Givens noted.
Many studies have linked depression to excess morbidity and mortality in elderly patients because of insufficient screening and detection and inadequate treatment. The findings of this study suggest that identifying depressed patients and offering them pharmacologic therapy may not be enough. “There is a need for more patient education and dialogue about the characteristics of current antidepressant therapy,” she concluded.
NEW ORLEANS — Fears and misconceptions about antidepressant medications contribute to older adults' reluctance to use pharmacologic treatment for depression, a qualitative study has shown.
“Depression is highly prevalent but undertreated in elderly primary care patients, despite the availability of effective medications,” Jane L. Givens, M.D., reported at the annual meeting of the Society of General Internal Medicine. Among the patient-level factors preventing appropriate treatment in this population are fear of addiction, concern about unnatural happiness or inability to feel grief and sadness, and fear of side effects.
Dr. Givens and her colleagues at the University of Pennsylvania in Philadelphia recruited a subsample of 68 older adults (mean age 75 years) with depression who participated in one of two qualitative, randomized treatment studies—the Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT) or the Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E). Each of the patients participated in semistructured home-based interviews, which were audiotaped, transcribed, and entered into qualitative data analysis software for coding and analysis.
“Four themes emerged from this review,” Dr. Givens said. “Many expressed a fear of needing to take antidepressants for the rest of their lives or of becoming addicted. Some did not want to be unnaturally happy or to mute their capacity to feel sadness or to 'face reality.'”
Other patients resisted treating symptoms of sadness associated with the loss of a loved one, and some had previous histories of treatment with psychiatric medications, including tranquilizers, and were concerned about the side effects, particularly sedation, Dr. Givens noted.
Many studies have linked depression to excess morbidity and mortality in elderly patients because of insufficient screening and detection and inadequate treatment. The findings of this study suggest that identifying depressed patients and offering them pharmacologic therapy may not be enough. “There is a need for more patient education and dialogue about the characteristics of current antidepressant therapy,” she concluded.
NEW ORLEANS — Fears and misconceptions about antidepressant medications contribute to older adults' reluctance to use pharmacologic treatment for depression, a qualitative study has shown.
“Depression is highly prevalent but undertreated in elderly primary care patients, despite the availability of effective medications,” Jane L. Givens, M.D., reported at the annual meeting of the Society of General Internal Medicine. Among the patient-level factors preventing appropriate treatment in this population are fear of addiction, concern about unnatural happiness or inability to feel grief and sadness, and fear of side effects.
Dr. Givens and her colleagues at the University of Pennsylvania in Philadelphia recruited a subsample of 68 older adults (mean age 75 years) with depression who participated in one of two qualitative, randomized treatment studies—the Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT) or the Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E). Each of the patients participated in semistructured home-based interviews, which were audiotaped, transcribed, and entered into qualitative data analysis software for coding and analysis.
“Four themes emerged from this review,” Dr. Givens said. “Many expressed a fear of needing to take antidepressants for the rest of their lives or of becoming addicted. Some did not want to be unnaturally happy or to mute their capacity to feel sadness or to 'face reality.'”
Other patients resisted treating symptoms of sadness associated with the loss of a loved one, and some had previous histories of treatment with psychiatric medications, including tranquilizers, and were concerned about the side effects, particularly sedation, Dr. Givens noted.
Many studies have linked depression to excess morbidity and mortality in elderly patients because of insufficient screening and detection and inadequate treatment. The findings of this study suggest that identifying depressed patients and offering them pharmacologic therapy may not be enough. “There is a need for more patient education and dialogue about the characteristics of current antidepressant therapy,” she concluded.