Kazi Ishtiak-Ahmed, Christopher Rohde, Ole Köhler-Forsberg, Kaj Sparle Christensen, Christiane Gasse
{"title":"抑郁症治疗轨迹及相关社会决定因素：丹麦首次接受抑郁症治疗的 66540 名老年人的三年随访研究》。","authors":"Kazi Ishtiak-Ahmed, Christopher Rohde, Ole Köhler-Forsberg, Kaj Sparle Christensen, Christiane Gasse","doi":"10.1002/gps.70006","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>This study aimed to describe depression treatment patterns, identify unique trajectory groups using a group-based trajectory approach, and explore associated social determinants in older adults undergoing first-time depression treatment during a 3-year follow-up.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This Danish register-based cohort study included all adults aged ≥ 65 who initiated depression treatment by redeeming first-time antidepressant prescriptions (no prescriptions in the last 10 years) between 2006 and 2015. The outcome of interest during the 2-year follow-up was depression treatment, assessed as antidepressant prescriptions redemptions and psychiatric hospital contacts for depression. Latent class growth analyses were applied to model treatment trajectories during 3 years. Multinomial logistic regression analyses were used to analyze adjusted associations between social determinates and trajectory group membership.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among the 66,540 older adults (55.2% females, mean age: 77.3 years), we identified three distinct groups with unique patterns of depression treatment trajectories: ‘brief-treatment’ where individuals stopped depression treatment within 6 months (33.7%); ‘gradual-withdrawal’ (26.5%) where treatment was gradually stopped over 2 years; and ‘persistent-treatment’ where individuals continued depression treatment for the entire 3 years (39.8%). Females, single-person households, and residents of less-urbanized regions were associated with higher odds of membership in the ‘persistent-treatment’ group, while older age, widowhood or separation, and non-Danish ethnicities were associated with lower odds.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Three distinct patterns of depression treatment trajectories were identified in older adults, indicating differential clinical courses of depression—potentially influenced by social determinants, including sex, marital status, urban residence, and ethnicity. Early patient stratification and targeted interventions are crucial in depression care for older adults.</p>\n </section>\n </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70006","citationCount":"0","resultStr":"{\"title\":\"Depression Treatment Trajectories and Associated Social Determinants: A Three-Year Follow-Up Study in 66,540 Older Adults Undergoing First-Time Depression Treatment in Denmark\",\"authors\":\"Kazi Ishtiak-Ahmed, Christopher Rohde, Ole Köhler-Forsberg, Kaj Sparle Christensen, Christiane Gasse\",\"doi\":\"10.1002/gps.70006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>This study aimed to describe depression treatment patterns, identify unique trajectory groups using a group-based trajectory approach, and explore associated social determinants in older adults undergoing first-time depression treatment during a 3-year follow-up.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This Danish register-based cohort study included all adults aged ≥ 65 who initiated depression treatment by redeeming first-time antidepressant prescriptions (no prescriptions in the last 10 years) between 2006 and 2015. The outcome of interest during the 2-year follow-up was depression treatment, assessed as antidepressant prescriptions redemptions and psychiatric hospital contacts for depression. Latent class growth analyses were applied to model treatment trajectories during 3 years. Multinomial logistic regression analyses were used to analyze adjusted associations between social determinates and trajectory group membership.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Among the 66,540 older adults (55.2% females, mean age: 77.3 years), we identified three distinct groups with unique patterns of depression treatment trajectories: ‘brief-treatment’ where individuals stopped depression treatment within 6 months (33.7%); ‘gradual-withdrawal’ (26.5%) where treatment was gradually stopped over 2 years; and ‘persistent-treatment’ where individuals continued depression treatment for the entire 3 years (39.8%). Females, single-person households, and residents of less-urbanized regions were associated with higher odds of membership in the ‘persistent-treatment’ group, while older age, widowhood or separation, and non-Danish ethnicities were associated with lower odds.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Three distinct patterns of depression treatment trajectories were identified in older adults, indicating differential clinical courses of depression—potentially influenced by social determinants, including sex, marital status, urban residence, and ethnicity. 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Depression Treatment Trajectories and Associated Social Determinants: A Three-Year Follow-Up Study in 66,540 Older Adults Undergoing First-Time Depression Treatment in Denmark
Objective
This study aimed to describe depression treatment patterns, identify unique trajectory groups using a group-based trajectory approach, and explore associated social determinants in older adults undergoing first-time depression treatment during a 3-year follow-up.
Methods
This Danish register-based cohort study included all adults aged ≥ 65 who initiated depression treatment by redeeming first-time antidepressant prescriptions (no prescriptions in the last 10 years) between 2006 and 2015. The outcome of interest during the 2-year follow-up was depression treatment, assessed as antidepressant prescriptions redemptions and psychiatric hospital contacts for depression. Latent class growth analyses were applied to model treatment trajectories during 3 years. Multinomial logistic regression analyses were used to analyze adjusted associations between social determinates and trajectory group membership.
Results
Among the 66,540 older adults (55.2% females, mean age: 77.3 years), we identified three distinct groups with unique patterns of depression treatment trajectories: ‘brief-treatment’ where individuals stopped depression treatment within 6 months (33.7%); ‘gradual-withdrawal’ (26.5%) where treatment was gradually stopped over 2 years; and ‘persistent-treatment’ where individuals continued depression treatment for the entire 3 years (39.8%). Females, single-person households, and residents of less-urbanized regions were associated with higher odds of membership in the ‘persistent-treatment’ group, while older age, widowhood or separation, and non-Danish ethnicities were associated with lower odds.
Conclusions
Three distinct patterns of depression treatment trajectories were identified in older adults, indicating differential clinical courses of depression—potentially influenced by social determinants, including sex, marital status, urban residence, and ethnicity. Early patient stratification and targeted interventions are crucial in depression care for older adults.
期刊介绍：
The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers.
The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.
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