Prevalence and treatment of diagnosed depression among elderly nursing home residents in Ohio
Prevalence and treatment of diagnosed depression among elderly nursing home residents in Ohio
复制标题
DOI：
10.1016/j.jamda.2007.07.010
复制
发表时间：
2007-11-01
影响因子：
7.6
通讯作者：
Crystal, Stephen
中科院分区：
文献类型：
--
作者：
Levin, Carrie A.;Wei, Wenhui;Crystal, Stephen
目的：要检查的患病率和老年疗养院居民诊断抑郁症的治疗，并确定居民和设施的特点与诊断和treatment.Design，设置，和参与者：记录抑郁症，药物治疗，心理治疗，社会人口统计学和医疗特征，从俄亥俄州的最小数据集76 735居民在921疗养院。这些数据与在线调查认证和报告系统数据合并，以研究设施特征的影响。卡方统计用于检验抑郁症诊断和治疗的组间差异。多元Logistic回归分析被诊断为抑郁症的患病率，并在诊断，接受任何treatment.Results：有48%的居民谁有一个积极的抑郁症的诊断，在这些诊断，23%没有接受治疗，74%接受抗抑郁药，0.5%接受心理治疗，2%接受两者。非裔美国人、严重认知障碍者和政府机构中的人被诊断出来的可能性较小。85岁及以上的居民、非裔美国人、患有严重精神疾病的人、患有严重ADL或认知障碍的人以及居住在有4项或更多缺陷的设施中的人接受治疗的可能性较小。结论：老年居民抑郁症的诊断和治疗存在显着差异。非裔美国人和有身体和认知障碍的居民等残疾群体不太可能得到诊断和治疗。我们的研究结果表明，工作需要做的养老院环境，以提高所有居民的抑郁症护理质量。
Objectives: To examine the prevalence and treatment of diagnosed depression among elderly nursing home residents and determine the resident and facility characteristics associated with diagnosis and treatment.Design, Setting, and Participants: Documented depression, pharmacotherapy, psychotherapy, sociodemographics, and medical characteristics were obtained from Ohio's Minimum Data Set for 76 735 residents in 921 nursing homes. The data were merged with Online Survey Certification and Reporting System data to study the impact of facility characteristics. Chi-squared statistics were used to test group differences in depression diagnosis and treatment. Multiple logistic regressions were used to examine the prevalence of diagnosed depression, and among those diagnosed, of receiving any treatment.Results: There were 48% of residents who had an active depression diagnosis; among those diagnosed, 23% received no treatment; 74% received antidepressants; 0.5% received psychotherapy; and 2% received both. African Americans, the severely cognitively impaired, and those in government facilities were less likely to be diagnosed. Residents aged 85 and older, African Americans, individuals with severe mental illness, those with severe ADL or cognitive impairment, and individuals living in a facility with 4 or more deficiencies were less likely to receive treatment.Conclusion: Significant disparities exist both in diagnosis and treatment of depression among elderly residents. Disadvantaged groups such as African Americans and residents with physical and cognitive impairments are less likely to be diagnosed and treated. Our results indicate that work needs to be done in the nursing home environment to improve the quality of depression care for all residents.