Psychological interventions key for keeping depression at bay
One of the most common mental health disorders among the elderly is depression, and things are not getting any easier since the ageing population continues to rise. Researchers from Sweden's Nordic School of Public Health have found that psychological interventions play a critical role in preventing depressive symptoms among people who are 65 years and older. Their study was funded in part by the DATAPREV ('Developing the evidence base for mental health promotion and prevention in Europe: a database of programmes and the production of guidelines for policy and practice') project, which clinched EUR 997 621 under the EU's Sixth Framework Programme (FP6) to enhance the evidence base in policy research for mental health promotion and protection.
The researchers assessed various forms of psychosocial interventions and determined that social activities hold the most weight for giving mental health of older adults a boost. The results of their study were published in the Journal of Aging and Health.
'Meaningful social activities adapted to the older adults' individual needs and abilities should be recognised in the planning of older care,' explained Anna Forsman, PhD student at the Nordic School of Public Health, and the lead author of the study.
The researchers also found no significant effect for interventions centred on physical exercise, skill training, support groups, reminiscence, or interventions with combined content.
The study was based on systematic searchers in 11 electronic databases until October 2009. The main objective was to compile and assess evidence-based knowledge and good examples on how to prevent the onset of depression and promote the mental health among the elderly.
Coordinated by the Academic Centre for Social Sciences in the Netherlands, the DATAPREV project brought together researchers from the Czech Republic, Spain, Austria, Poland, Finland and the UK.
In another study on depression, researchers from the Nordic School of Public Health and the University of Gothenburg have found that Swedish women's use of antidepressants is twice as high as that of Swedish men. But only one fifth of both women and male new users fill only one prescription.
'This can be an indication of choices being made to end treatment before the recommended time,' says Dr Karolina Andersson Sundell, a researcher at the Nordic School of Public Health.
The team performed a register study of young adults who bought at least one antidepressant in 2006. They found that between 4% to 13% of Swedes aged 20-34 use antidepressants. Women represent a large portion of that group. The study shows that of those who use antidepressants, every tenth also buys antipsychotics, and some only bought their medication once, showing that the drug was not used optimally.
'What we need to do now is to monitor this for a longer period of time to see if they return and purchase antidepressants again, at a later stage,' Dr Andersson Sundell points out. 'We currently lack knowledge regarding the reasons for why only one purchase is made, meaning additional studies are required. Previous international research however indicates that patients often make this choice independently and seldom inform their prescription provider why they decided to stop taking the medication.'
The team discovered a higher mortality rate among both women and men using antidepressants in combination with mood stabilisers. But lithium use did not follow this pattern.
'One possible reason is that lithium users receive better follow-ups,” Dr Andersson Sundell says. 'Increased mortality was also seen among the group of individuals who filled prescriptions for both antidepressants and antipsychotics. Further studies are needed to map the reasons for the elevated mortality rates.'
Nordic School of Public Health
Journal of Aging and Health
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