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@ARTICLE{Boehlen:143207,
author = {F. H. Boehlen and J. Freigofas and W. Herzog and A. D. Meid
and K.-U. Saum$^*$ and B. Schoettker$^*$ and H. Brenner$^*$
and W. E. Haefeli and B. Wild},
title = {{E}vidence for underuse and overuse of antidepressants in
older adults: {R}esults of a large population-based study.},
journal = {International journal of geriatric psychiatry},
volume = {34},
number = {4},
issn = {1099-1166},
address = {Chichester [u.a.]},
publisher = {Wiley},
reportid = {DKFZ-2019-00806},
pages = {539 - 547},
year = {2019},
abstract = {Depression is common among elderly people. However,
diagnosis and adequate treatment is frequently difficult.
Research on underuse and overuse of antidepressants in
elderly persons is scarce. This study investigates the
utilization and appropriateness of pharmacological and
psychological depression treatment in a large cohort of
community-dwelling adults.A subsample of 3117 participants
(aged 55-85 y) of the third follow-up (2008-2010) of the
large population-based German ESTHER study was included.
Depression was assessed using the eight-item Patient Health
Questionnaire (PHQ-8). In the course of a home visit, study
doctors collected complete information on medication.
Logistic regression analyses were conducted to determine the
relationship of depression with both underuse and overuse of
antidepressants. The analyses were then adjusted for
socioeconomic variables, psychosomatic comorbidities, and
motivation to seek help.One hundred sixty-three participants
$(5.2\%;$ $95\%$ confidence interval [CI], 4.5-6.1)
fulfilled the criteria for major depression. Underuse of
antidepressants was present in 126 depressed participants
$(77.3\%;$ 70.1-83.5). Persons who were motivated to seek
help, who had an established depression diagnosis, or who
were taking more than five different medications had lower
odds of underuse. Anxiety was associated with higher odds
for underuse. Overuse of antidepressants (prescription
without clinical indication) was found in 96 cases
$(41.7\%;$ 35.3-48.4) of all antidepressant
prescriptions.Depression treatment in older adults is
frequently insufficient; it appears to depend on diagnosis
as well as the patients' motivation to seek help. Education
regarding the diagnosis of depression in the elderly as well
as guidelines for appropriate treatment is needed.},
cin = {C070 / C120},
ddc = {610},
cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:30623499},
doi = {10.1002/gps.5047},
url = {https://inrepo02.dkfz.de/record/143207},
}