Depression untreated in elderly
By Diana Penner
IndyStar.com,
April 7, 2003
Men less likely than women; blacks, Latinos less likely than
whites to get help, study finds.
Older men are less likely than older women to seek
treatment for depression, and older blacks and Latinos seek help less
often than their white counterparts, new research says.
The results are being published today in the Journal of
the American Geriatrics Society. They are a follow-up to a multicenter
study, published in December, that included the Indiana University School
of Medicine.
The $11 million study, funded by four foundations,
involved 1,801 adults, ages 60 and older, in five states. In Indianapolis,
patients were seen through Wishard Memorial Hospital, and all were
diagnosed with depression.
The first research gleaned from the study showed older
adults were more likely to recover from depression when treatment was part
of their normal medical care, rather than handled separately, as is the
norm.
The new research involved further analysis of the data.
Most of the patients in the study had had prior episodes
of depression but had not sought treatment, said Dr. Jürgen Unützer,
associate professor of psychiatry at the David Geffen School of Medicine
at the University of California-Los Angeles.
Overall, 83 percent of the study participants reported
having had symptoms of depression for two or more years, and 71 percent
said they'd had two or more episodes. But only 65 percent said they had
ever been treated for depression.
The report published today does not include statistics,
but the authors said men consistently were less likely to receive
treatment for depression than women, as were blacks and Latinos compared
with whites.
Men tend to minimize their symptoms and to be embarrassed
by them, Unützer said. He recalled one male patient's response while
being counseled for depression.
"He said, 'Boy, this doesn't really sound like a
manly set of symptoms,' " Unützer said.
There also are some indications that health care providers
are less likely to ask men about depressive symptoms, compounding the
problem, he said. The worst-case scenario, Unützer said, would be a male
patient and a male medical professional who both are uncomfortable talking
about mental health issues.
It's not clear precisely why Latinos and blacks are less
likely to seek treatment, but cultural differences likely come into play,
said Dr. Hugh Hendrie, an IU professor of psychiatry.
Both psychiatrists said a key message of the study is that
health care professionals and family members should be on the alert for
possible warning signs of depression in older Americans and urge them to
seek treatment.
While women who are depressed may become withdrawn and
quiet and appear sad, men might show different symptoms, including anger
and aggression, they said. Men also tend to mask depression by drinking
too much.
Patients need to overcome their own discomfort and push
for treatment if they know they have signs of depression, Unützer said,
and not count on a health care professional to notice.
"I think the most important thing, really, is not to
wait for the doctor to ask about it," he said.
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