Treatment, outcome and predictors of response in elderly depressed in-patients

Background Full recovery rates in naturalistic studies of the treatment of elderly depressives are invariably lower than in clinical trials. This may be-the result of inadequate treatment due to the lack of clear treatment strategy recommendations for the elderly. Method This is a naturalistic prospective study of depressed elderly in-patients in three Dutch psychiatric hospitals. Patients were included when they suffered from any mood disorder according to DSM-III-R criteria. Severity of the depression was measured on the Montgomery-Asberg Rating Scale. Results Antidepressants were prescribed to more than 90% of the patients. More than half of them received only one treatment. The dose of the antidepressants was less than the recommended dose for adults in 55% of cases. Full recovery from the depressive episode was achieved in less than half of the patients (33-45%). Conclusions In the present study a relatively poor outcome of the antidepressant treatment of elderly depressives has been found. A combination of low treatment expectations and fear of vigorous treatment seems to have been important.