Neuropsychiatric Disease and Treatment (May 2018)
The characteristics of understanding of depression among older patients treated with antidepressants: a comparison between older and younger patients
Abstract
Tetsu Tomita,1 Shuhei Kudo,2 Norio Sugawara,3 Akira Fujii,4 Koji Tsuruga,5 Yasushi Sato,1 Masamichi Ishioka,6 Kazuhiko Nakamura,1 Norio Yasui-Furukori1 1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan; 2Department of Psychiatry, Tsugaru General Hospital, Goshogawara, Japan; 3Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan; 4Department of Mental Health, Mutsu General Hospital, Mutsu, Japan; 5Department of Psychiatry, Aomori Prefectural Tsukushigaoka Hospital, Aomori, Japan; 6Department of Psychiatry, Minato Hospital, Hachinohe, Japan Background: To reveal characteristics of understanding of depression among older patients, we reanalyzed the data from a previous study of patients who were administered antidepressants.Methods: A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire consisting of eight items: depressive symptoms, the course of depression, the cause of depression, the treatment plan, the duration of antidepressant use, how to discontinue antidepressants, the side effects of antidepressants, and psychotherapy. Each item consisted of the following two questions: “Have you received an explanation from the doctor in charge?” and “How much do you understand about your treatment?”. The level of understanding was rated on a scale of 0–10 (11 anchor points). Subjects were divided into two groups: younger patients who were <65 years of age and older patients who were ≥65 years of age. Results: Older patients with depression showed lower levels of understanding of depression and did not receive sufficient psychoeducation from their physicians, but their understanding of depression might not be associated with their remission. In the younger group, the scores of understanding of the course of depression, the treatment plan, how to discontinue antidepressants, and psychotherapy items, and the total understanding score of remitters, were significantly higher than those of non-remitters. In contrast, there were no significant differences in the items score or total score between remitters and non-remitters in the older group.Conclusion: Older patients showed lower levels of understanding of depression and did not appear to receive sufficient psychoeducation, but their understanding of depression might not be associated with their remission. Keywords: depression, psychoeducation, older patients, younger patients