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Depression and use of antidepressants in Swedish nursing homes: a 12-month follow-up study.

Midlöv, Patrik LU ; Andersson, Martin L LU ; Östgren, Carl Johan LU and Mölstad, Sigvard LU (2014) In International Psychogeriatrics 26(4). p.669-675
Abstract
ABSTRACT Background: The prescription of antidepressants in nursing homes has increased markedly since the introduction of SSRIs, while at the same time depressive symptoms often go unrecognized and untreated. The aim of this study was to examine whether depression among residents in nursing homes is treated adequately. Methods: A sample of 429 participants from 11 Swedish nursing homes was selected and was assessed with the Cornell Scale for Depression in Dementia (CSDD) and using medical records and drug prescription data. For 256 participants a follow-up assessment was performed after 12 months. Results: The prevalence of depression, according to medical records, was 9.1%, and the prevalence of CSDD score of ≥8 was 7.5%. Depression... (More)
ABSTRACT Background: The prescription of antidepressants in nursing homes has increased markedly since the introduction of SSRIs, while at the same time depressive symptoms often go unrecognized and untreated. The aim of this study was to examine whether depression among residents in nursing homes is treated adequately. Methods: A sample of 429 participants from 11 Swedish nursing homes was selected and was assessed with the Cornell Scale for Depression in Dementia (CSDD) and using medical records and drug prescription data. For 256 participants a follow-up assessment was performed after 12 months. Results: The prevalence of depression, according to medical records, was 9.1%, and the prevalence of CSDD score of ≥8 was 7.5%. Depression persisted in more than 50% of cases at the 12-month follow-up. Antidepressants were prescribed to 33% of the participants without a depression diagnosis or with a CSDD score of <8. 46.2% of all participants were prescribed antidepressants. 14% of the participants without a depression diagnosis or with a CSDD score of <8 had psychotropic polypharmacy. 15.2% of all participants had psychotropic polypharmacy, which persisted at the 12-month follow-up in three-quarters of cases. Conclusion: The prescription of antidepressants in frail elderly individuals is extensive and may be without clear indication. The clinical implication is that there is a need for systematic drug reviews at nursing homes, paying special attention to the subjects which are on antidepressants. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Psychogeriatrics
volume
26
issue
4
pages
669 - 675
publisher
Cambridge University Press
external identifiers
  • pmid:24331291
  • wos:000332926900017
  • scopus:84896399660
ISSN
1741-203X
DOI
10.1017/S1041610213002354
language
English
LU publication?
yes
id
0bdeff31-a89a-4661-acfe-706c14ff060d (old id 4223876)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24331291?dopt=Abstract
date added to LUP
2014-01-04 12:46:29
date last changed
2017-09-03 03:10:59
@article{0bdeff31-a89a-4661-acfe-706c14ff060d,
  abstract     = {ABSTRACT Background: The prescription of antidepressants in nursing homes has increased markedly since the introduction of SSRIs, while at the same time depressive symptoms often go unrecognized and untreated. The aim of this study was to examine whether depression among residents in nursing homes is treated adequately. Methods: A sample of 429 participants from 11 Swedish nursing homes was selected and was assessed with the Cornell Scale for Depression in Dementia (CSDD) and using medical records and drug prescription data. For 256 participants a follow-up assessment was performed after 12 months. Results: The prevalence of depression, according to medical records, was 9.1%, and the prevalence of CSDD score of ≥8 was 7.5%. Depression persisted in more than 50% of cases at the 12-month follow-up. Antidepressants were prescribed to 33% of the participants without a depression diagnosis or with a CSDD score of &lt;8. 46.2% of all participants were prescribed antidepressants. 14% of the participants without a depression diagnosis or with a CSDD score of &lt;8 had psychotropic polypharmacy. 15.2% of all participants had psychotropic polypharmacy, which persisted at the 12-month follow-up in three-quarters of cases. Conclusion: The prescription of antidepressants in frail elderly individuals is extensive and may be without clear indication. The clinical implication is that there is a need for systematic drug reviews at nursing homes, paying special attention to the subjects which are on antidepressants.},
  author       = {Midlöv, Patrik and Andersson, Martin L and Östgren, Carl Johan and Mölstad, Sigvard},
  issn         = {1741-203X},
  language     = {eng},
  number       = {4},
  pages        = {669--675},
  publisher    = {Cambridge University Press},
  series       = {International Psychogeriatrics},
  title        = {Depression and use of antidepressants in Swedish nursing homes: a 12-month follow-up study.},
  url          = {http://dx.doi.org/10.1017/S1041610213002354},
  volume       = {26},
  year         = {2014},
}