Early Treatment Of Depression Research Articles

Detecting Depression Using an Ensemble Logistic Regression Model Based on Multiple Speech Features.

Early intervention for depression is very important to ease the disease burden, but current diagnostic methods are still limited. This study investigated automatic depressed speech classification in a sample of 170 native Chinese subjects (85 healthy controls and 85 depressed patients). The classification performances of prosodic, spectral, and glottal speech features were analyzed in recognition of depression. We proposed an ensemble logistic regression model for detecting depression (ELRDD) in speech. The logistic regression, which was superior in recognition of depression, was selected as the base classifier. This ensemble model extracted many speech features from different aspects and ensured diversity of the base classifier. ELRDD provided better classification results than the other compared classifiers. A technique for identifying depression based on ELRDD, ELRDD-E, was here suggested and tested. It offered encouraging outcomes, revealing a high accuracy level of 75.00% for females and 81.82% for males, as well as an advantageous sensitivity/specificity ratio of 79.25%/70.59% for females and 78.13%/85.29% for males.

Depression is a major determinant of both disease-specific and generic health-related quality of life in people with severe COPD.

The quality of life of patients with chronic obstructive pulmonary disease (COPD) decreases significantly as the disease progresses; those with severe COPD are affected most. This article investigates predictors of the disease-specific and generic health-related quality of life (HRQL) in patients with severe COPD. This multicentre prospective cross-sectional study enrolled 80 patients with severe COPD. At enrolment, all patients completed a disease-specific instrument, the St George’s Respiratory Questionnaire (SGRQ), and a generic instrument, the Short Form 36 Health Survey Questionnaire (SF-36). The data were analyzed by Pearson’s correlation and multiple linear regression. The mean age of the patients was 66 ± 8 years; 93% were males. The SGRQ and SF-36 scores were not influenced by age or sex. Depression, dyspnea, the number of exacerbations, and exercise capacity significantly predicted the total SGRQ score (p < 0.05). Depression was the strongest determinant of the total SGRQ score. The SF-36 physical component summary scores were related to depression, dyspnea, and the number of exacerbations (p < 0.05). In comparison, the SF-36 mental component summary scores were related to depression and anxiety (p < 0.05). Depression is a significant determinant of both the disease-specific and generic HRQL in patients with severe COPD. Screening and early intervention for depression in patients with severe COPD could improve the HRQL.

Predictors of Quality of Life in Pregnant Women Visiting Health Centers of Tabriz, Iran

Background & aim: To have successful pregnancy, it is necessary to focus on the mother’s quality of life during pregnancy. This study was conducted to determine the predictors of quality of life among Iranian pregnant women. Methods: This cross-sectional study was conducted on 565 pregnant women visiting health centers of Tabriz, Iran, 2015. The participants were selected using the cluster sampling method. Data were collected using socio-demographic and obstetrics characteristics questionnaire, Edinburgh Postnatal Depression Scale, and a specific questionnaire for quality of life in pregnancy. Data were analyzed by SPSS, version 16. General linear model was used to estimate the effects of the independent variables (depressive symptoms and socio-demographic and obstetrics characteristics) on the dependent variable (quality of life). Results: The mean of the total score of quality of life was 2.9±0.3 from the achievable score range of 0-4. There was a significant negative correlation between depressive symptoms and quality of life (r=-0.53, p <0.001). Depressive symptoms, gestational age, and the place of receiving prenatal care were the predictors of quality of life during pregnancy. Women who had low scores of depressive symptoms, were at the second trimester, and received prenatal care from health centers had higher score of quality of life. Conclusion: The most important components affecting pregnant women’s quality of life are mother’s depressive symptoms, gestational age, and place of receiving prenatal care. Interventions such as screening and early treatment of depression must be implemented to improve the quality of life.

Tryptophan-kynurenine and lipid related metabolites as blood biomarkers for first-episode drug-naïve patients with major depressive disorder: An exploratory pilot case-control study

BackgroundEarly intervention in depression has been critical to prevent its negative impact including suicide. Recent blood biomarker studies for major depressive disorder (MDD) have suggested that tryptophan-kynurenine and lipid related metabolites are involved in the pathophysiology of MDD. However, there have been limited studies investigating these blood biomarkers in first-episode drug-naïve MDD, which are particularly important for early intervention in depression. MethodsAs an exploratory pilot case-control study, we examined the above blood biomarkers, and analyzed how these biomarkers are associated with clinical variables in first-episode drug-naïve MDD patients, based on metabolome/lipidome analysis. ResultsPlasma tryptophan and kynurenine levels were significantly lower in MDD group (N = 15) compared to healthy controls (HC) group (N = 19), and plasma tryptophan was the significant biomarker to identify MDD group (area under the curve = 0.740). Lower serum high density lipoprotein-cholesterol (HDL-C) was the predictive biomarker for severity of depression in MDD group (R2 = 0.444). Interestingly, depressive symptoms were variously correlated with plasma tryptophan-kynurenine and lipid related metabolites. Moreover, plasma tryptophan-kynurenine metabolites and cholesteryl esters (CEs) were significantly correlated in MDD group, but not in HC group. LimitationsThis study had small sample size, and we did not use the multiple test correction. ConclusionsThis is the first study to suggest that not only tryptophan-kynurenine metabolites but also HDL-C and CEs are important blood biomarkers for first-episode drug-naïve MDD patients. The present study sheds new light on early intervention in clinical practice in depression, and further clinical studies especially large-scale prospective studies are warranted.

Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial

BackgroundSuicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. MethodsWe developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. ResultsThis suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. LimitationsDesign was a single-arm study with relatively small sample size and short-term follow up. ConclusionsThe present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates.

Exploring the excess mortality due to depressive symptoms in a community-based sample: The role of Alzheimer's Disease

BackgroundDepression has been associated with increased risk of death. However, there is lack of studies exploring such relationship in the context of dementia. Given the high prevalence of both depression and Alzheimer's Disease (AD), investigating their temporal association with mortality is of public health relevance. MethodsLongitudinal data from the WHICAP study were analyzed (1958 individuals aged ≥65 years). Depressive symptoms were assessed with the 10-item Center for Epidemiologic Studies Depression Scale (CES-D). Respondents were identified as having AD if they satisfied the criteria of the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer’s disease. Cox regressions analyses were performed to determine the association between depressive symptoms and risk of all-cause mortality using the overall sample, and by AD status. ResultsDepressive symptoms were significantly associated with higher mortality risk after adjusting for all potential covariates in the overall sample (HR=1.22; 95% CI=1.02, 1.46) and in individuals with incident AD (HR=1.88; 95% CI=1.12, 3.18). LimitationsThe CES-D does not measure clinical depression but depressive symptomatology. Since those who were exposed to known risk factors for mortality are likely to die prematurely, our results may have been skewed to the individuals with longer survival. ConclusionsStrategies focusing on prevention and early treatment of depression in the elderly may have a beneficial effect not only on patient quality of life and disability, but may also increase survival in the context of AD.

Early intervention for depression and anxiety in 16–18-year-olds: Protocol for a feasibility cluster randomised controlled trial of open-access psychological workshops in schools (DISCOVER)

Adolescence is a vulnerable period for the development of mental health problems. The DISCOVER intervention aims to provide accessible, acceptable and cost-effective psychological support for stressed adolescents in inner-city secondary schools. The intervention uses age-appropriate cognitive-behavioural therapy (CBT) methods and materials, delivered in an interactive 1-day workshop with additional telephone support. An open-access entry route allows students to self-refer. This protocol describes a feasibility cluster randomised controlled trial (RCT) comparing DISCOVER with a waitlist control condition. The study will run across 10 clusters (secondary schools) in the inner London Boroughs of Southwark and Lambeth. Participants are students aged over 16years who are seeking help with anxiety and/or depressive symptoms. Key feasibility parameters relate to the proportion of students willing to participate in the research following publicity events; the proportion of students who complete the intervention; and response rates for outcome measures. Outcome variance estimates and intra-cluster correlations will be obtained for future power calculations. Qualitative methods will be used to explore the acceptability of the intervention and research procedures for students and school staff. The feasibility of an economic evaluation will also be examined. The results will (i) determine the appropriateness of proceeding to a definitive full-scale trial; and (ii) inform the development of an optimised version of the DISCOVER intervention that can be tested within feasible parameters.

Study of depression among adolescent students of rural maharashtra and its association with socio-demographic factors: a cross-sectional study

Introduction: Depression is the most common psychiatric disorder that appears in adolescents. It has an adverse effect on physical as well as mental health. Many adolescents remain undiagnosed due to no accessibility to clinics. Objectives: To study demographic factors and their association with depression among adolescents of rural Maharashtra. Methods: A cross sectional study was conducted on 300 students (30 of either sex from 8th to 12th class). 6 item KADS (Kutcher Adolescent Depression Scale), BG Prasad’s modified socioeconomic scale and demographic data were collected from volunteers. Results: 6.66% of students were screened positive for depression by the scale. No statistical difference was found in number of students with depression with respect to sex, class and socioeconomic status. However the residence and type of family showed significant difference in number students of depression. Conclusion: the KADS is a good screening tool for depression and should be implemented for adolescents studying in rural areas for prevention and early treatment of depression.

Delays in depression treatment among Korean population.

Delays in mental health service utilization for patients with depression have been observed globally. To elucidate some aspects of delays, age-related associations with a series of variables representing different stages of mental health service use were studied concurrently. A total of 1,433 patients with depression participated in a nationwide Korean Depressive Patient Survey through the collaboration of 70 psychiatric clinics and hospitals. Using logistic and Poisson regression, we investigated whether there is variation in the associations by age. Patients with depression in South Korea spent 3.4 years on average before starting a first depression treatment after the onset of depression, and 58% of them entered depression treatment in the first year of onset. Early onset appeared to lower the chance of "early depression treatment": e.g., adjusted odds ratio (OR)s for onset age of 40-54, 25-39 and <25 versus ≥55 were 0.65 (95% CI = 0.44, 0.94), 0.36 (95% CI = 0.16, 0.81) and 0.18 (95% CI = 0.06, 0.48), respectively. In contrast, favorable associations of early onset with "self-recognition as depression" and "number of nonpsychiatric clinics attended" before visiting psychiatrist were found. Younger cohorts were associated with more positive attitudes toward all mental health utilization measures. Delays in depression treatment are lengthy in South Korea. Those with early onset are more likely to have delayed depression treatment but are more willing to seek help from a psychiatrist once they sought for the treatment.

Too Sick, Not Sick Enough?

A case vignette survey design was used to explore effects of treatment timing (early, delayed, or untreated) and depression treatment type (pharmacological or psychological) on components of depression stigma. The survey was distributed to two samples, 116 undergraduates (UGs) and 301 participants from the online service Amazon Mechanical Turk. As expected, extended untreated depression was associated with greater social distance and negative character evaluation than treated depression, and early treatment was associated with higher illness invalidity stigma (both samples) and illness responsibility stigma (UG sample only). Interaction effects suggested that pharmacotherapy, in comparison with psychotherapy, was more sensitive to the effects of treatment timing on stigma. Taken together, the pattern of results suggests that separate facets of stigma are associated with early depression treatment and prolonged untreated depression. Evidence for separate stigmatization of early treatment and extended illness holds important implications for antistigma campaigns.

Study of proportion and determinants of depression among college students in Mangalore city.

Background:Onset of depression is occurring earlier in life today than in past decades. Adolescence being transitional period from childhood to adulthood is a stage of emotional instability resulting from demand for separation and independence. Evidence suggests that early intervention for depression in children can improve long-term outcomes.Materials and Methods:This cross-sectional study was done in January 2010 to find out the prevalence of depression among pre university students in Mangalore city. Prevalence of depression was assessed using Beck's Depression Inventory II. Data was collected using a self-administered questionnaire.Results:Out of 308 participants, depression was seen among 79.2% students. A majority (41.2%) were found to be suffering from moderate followed by mild (26.6%) depression. Prevalence of depression (P = 0.027) and severity of depression (P = 0.0357) was found to significantly increase with age of the participants. Students of commerce were found to be significantly more depressed than students of science stream (P = 0.002). No association of depression with gender of participants or with the type of college they were studying in was observed.Conclusion:There is a need for college students to be educated about depression in order to improve recognition and diagnosis. Also student counselling service offering mental health assistance needs to be established at colleges.

Depressed mood and quality of life after subarachnoid hemorrhage

BackgroundCognitive impairment is widely considered the main cause of disability and handicap after subarachnoid hemorrhage (SAH). The impact of depression on recovery after SAH remains poorly defined. We sought to determine the frequency of post-SAH depression, identify risk factors for its development, and evaluate the impact of depression on quality of life (QOL) during the first year of recovery. MethodsWe prospectively studied 216 of 534 SAH patients treated between July 1996 and December 2001 with complete one-year follow-up data. Depression was evaluated with the Center for Epidemiological Studies Depression (CES-D) scale, cognitive status with the Telephone Interview for Cognitive Status (TICS), and QOL with the Sickness Impact Profile (SIP) 3 and 12months after SAH. ResultsDepressed mood occurred in 47% of patients during the first year of recovery; 26% were depressed at both 3 and 12months. Non-white ethnicity predicted early (3month) and late (12month) depressions; early depression was also predicted by previously-diagnosed depression, cigarette smoking, and cerebral infarction, whereas late depression was predicted by prior social isolation and lack of medical insurance. Depression was associated with inferior QOL in all domains of the SIP, and changes in depression status were associated with striking parallel changes in QOL, disability, and cognitive function during the first year of recovery. CES-D scores accounted for over 60% of the explained variance in SIP total scores, whereas TICS performance accounted for no more than 6%. ConclusionDepression affects nearly half of SAH patients during the first year of recovery, and is associated with poor QOL. Systematic screening and early treatment for depression are promising strategies for improving outcome after SAH.

Ethnic/Racial Differences in Depression among U.S. Primary Care Patients: Cultural Considerations in Screening and Detection

Screening and detection are essential building blocks for prevention and early treatment of depression. Despite their critical role in early identification and treatment, primary care physicians fail to recognize depression in about half of their patients. Because depressed patients of color tend to seek treatment in primary care settings, the need for greater attention to, and understanding of, ethnic and racial disparities in general practitioners' ability to detect cases of depression is compelling. The purpose of this article is to discuss the screening and detection of depression among patients from different U.S. ethnic/racial and cultural groups. Specifically, the objective is to identify within- and between-culture factors that may impact on symptom presentation for African-Americans, Asians, Hispanic/Latinos, and Native Americans, and subsequently on the diagnosis of depression in primary care settings. Implications for the role of allied health professionals, especially social workers, in enhancing the cultural competence of primary care doctors are discussed.

Effects of Tailored Case Management using a Gatekeeper for the Depressed Single-household Elderly Population -Focusing on the Mental Health Case Management-

Purpose: The aim of this study was to evaluate the effects of tailored case management using a gatekeeper on depression and life satisfaction in the single-household elderly population. Methods: The design of Quasi experiment was applied to compare the variables before and after the management. Ninety-seven people who had depression categorized by the Korean Geriatric Depression Scale. Results: Depression (t=11.22, p<.001) and life satisfaction (t=-5.36, p<.001) were improved after management in comparison to the results of pre-tests, and the differences were statistically significant. The difference in the pre-test and post-test scores of the support system (x 2 =13.89, p<.001) were significant, while the differences in the perception of depression (x 2 =.02, p=.891) and coping methods (x 2 =.34, p=.558) were not statistically significant. Conclusion: Tailored case management using a gatekeeper is effective to reduce the degree of depression and improve life satisfaction in the singlehousehold elderly population having depression. This study offers a model of individualized as well as systemic mental health care for the community of single-house hold elderly people as an effective means for prevention of and early intervention in depression.

Life review therapy for older adults with moderate depressive symptomatology: a pragmatic randomized controlled trial

BACKGROUND. Although there is substantial evidence for the efficacy of life review therapy as an early treatment of depression in later life, its effectiveness in natural settings has not been studied. The present study evaluates an intervention based on life review and narrative therapy in a large multi-site, pragmatic randomized controlled trial(RCT). METHOD. Life review therapy was compared with care as usual. The primary outcome was depressive symptoms;secondary outcomes were anxiety symptoms, positive mental health, quality of life, and current major depressive episode (MDE). To identify groups for whom the intervention was particularly effective, moderator analyses were carried out (on sociodemographic variables, personality traits, reminiscence functions, clinically relevant depressive and anxiety symptoms, and past MDEs). RESULTS. Compared with care as usual (n=102), life review therapy (n=100) was effective in reducing depressive symptoms, at post-treatment (d=0.60, B= -5.3, p<0.001), at 3-month follow-up (d=0.50, B= -5.0, p<0.001) and for the intervention also at 9-month follow-up (t=5.7, p<0.001). The likelihood of a clinically significant change in depressive symptoms was significantly higher [odds ratio (OR) 3.77, p<0.001 at post-treatment ; OR 3.76, p<0.001 at the 3-month follow-up]. Small significant effects were found for symptoms of anxiety and positive mental health.Moderator analyses showed only two significant moderators, the personality trait of extraversion and the reminiscence function of boredom reduction. CONCLUSIONS. This study shows the effectiveness of life review therapy as an early intervention for depression in an ecologically valid context, supporting its applicability to a broad target group. The intervention is also effective in reducing anxiety symptoms and strengthening positive mental health.

Les troubles dépressifs chez les patients atteints de cancer. Une étude marocaine

Depression is frequently associated with cancer; its prevalence varies considerably because of the heterogeneity of the populations studied and the different methods of assessment used. The prevalence of depression in cancer patients ranges from 0 to 58%. The study that we conducted had objectives to estimate the prevalence of depression in a population of cancer patients, to describe their socio-demographic and clinical profile and to determine the possible factors influencing the occurrence of depression in these patients. The study was conducted at the oncology department of the university hospital Mohammed VI in Marrakech, involving 100 cancer patients assigns different sites and stadiums. The instruments used were MINI (DSM-IV) for the diagnosis of depression, and Beck Depression Inventory to assess its severity. The results showed that the prevalence of depression was 15%, in which 26,7% was severe, 60% moderate and 13,3% mild. The depression was frequently encountered among women, from 37 to 50 years old, married, had never been enrolled in school or with a university degree, with a localized cancer, whose discovery was made very early (1 to 3 months) or which exceeds 49 months. The depression was also frequently present in patients who had an indifferent familial entourage to their disease, and for those that the cost of care was not the main cause of discomfort. Greater attention should be given to these cancer patients, with screening and early treatment of depression, for overall and multidisciplinary care and better quality of life.

Care by Phone Aids Early Depression Treatment

Care by Phone Aids Early Depression Treatment

Impact of Eating Psychopathology, Obsessive-Compulsion and Depression on Self-Harm Behavior in Patients with Eating Disorders

The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.

Prevention and early intervention for depression in young people – a practical possibility?

Many studies aimed at prevention and early intervention for mental disorders have focused on depressive disorder because it causes substantial disability. In this review, recent developments in prevention and early intervention with children and adolescents who are depressed are summarized. Despite early promise, there is little evidence that prevention of depression is a practical possibility at this stage. There is no clear evidence of effectiveness for universal programmes. Targeted programmes are more promising, with evidence of short-term reduction in depressive symptoms, and there are a few studies in which there is evidence of a reduced incidence of disorder. There are promising developments in efforts to screen for disorder, although there is a requirement for more effective therapy. Potential cost-savings are considerable, so it is imperative that the search continues for effective interventions for depression in young people. Attention to wider social issues that impact on mental health is also needed. Developing preventive services for depression is premature at this stage. There is evidence to support screening for depression and providing early intervention, but current treatments have limited effectiveness. There is a compelling need for further research in this area.

Depression Care May Extend Lives of Elderly Patients

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessDepression Care May Extend Lives of Elderly PatientsJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:15 Jun 2007https://doi.org/10.1176/pn.42.12.0015At age 91 “Earl” was in remarkably good health and excited about attending his 70th college class reunion. He was particularly looking forward to seeing his old college friend “Frank” there. During the reunion, however, Frank died, and Earl became extremely depressed. Eight months later Earl died as well. Would Earl have lived closer to the century mark or even beyond if he had not been depressed?Depression in older individuals has been strongly linked with an increased risk of dying from various medical illnesses (Psychiatric News, October 18, 2002). Also, several studies have suggested that treating older persons' depression can extend their lives.One was the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHED) trial. It found that use of a selective serotonin reuptake inhibitor was associated with a reduction in death over a 40-month period. The other was the Sertraline Anti-Depressant Heart Attack Randomized Trial (SAD-HART). It included subjects who had had a heart attack and were depressed. It found that there was a consistent trend, over a 24-week period, for subjects taking an antidepressant to have a lower death rate than subjects taking a placebo. However, the difference did not reach statistical significance (Psychiatric News, August 2, 2002).Now a new study headed by Joseph Gallo, M.D., an associate professor of family medicine and community health at the University of Pennsylvania, reported in the May 15 Annals of Internal Medicine, further suggests that depression treatment can extend the lives of seniors.The study included 396 people aged 60 or older with major depression and 203 with clinically significant minor depression. Half of those with major depression received care as usual in a primary care practice, and half received an experimental intervention. It was the same for those with less-severe depression. The intervention consisted of a depression-care manager working with a primary care physician to provide algorithm-based care.The researchers then followed the subjects for about four years to determine which ones died and why. Finally they assessed whether there was any significant difference in the rates of death between the major-depression subjects who had received usual care and those who had received the intervention. They also evaluated whether there was any significant difference in the rates of death between the minor-depression subjects who had received usual care and those who had received the intervention. In each of these analyses, they took possibly confounding factors such as age, gender, education, smoking status, cardiovascular disease, stroke, diabetes, cancer, cognition, comorbid medical conditions, and suicidal ideation into consideration.No significant differences in death rates were found for the minor-depression subjects, but significant differences were found for subjects with major depression. Specifically, major-depression subjects in the intervention arm of the study were significantly less likely to die over the follow-up period than were major-depression subjects in the usual-care arm. The risk of death was cut by 45 percent.Moreover, the benefit seemed to be limited to a reduction in deaths due to cancer. The reason for this finding, Gallo told Psychiatric News, might be because the “cause of death from death certificates isn't as reliable as vital status (whether someone died or not). So we can't make too much of this particular observation. However, there could be biological reasons why depression and cancer are related, or depression could interfere with a person's cancer being adequately detected and treated.”Gallo also hypothesized as to why his study seemed to produce more positive results than the two cardiovascular studies cited above. “The persons in our study were, for the most part, community-dwelling older adults, while the persons in the other studies were identified after a cardiac event,” he explained. “How depression affects medical illness and whether treatment affects mortality might differ depending on.. .how far along a person is in the course of their medical disease.”The take-home message from the two cardiovascular studies and their own, Gallo said, is that early treatment of depression in older individuals can not only relieve psychological distress, but may extend lives as well.The study was financed by the National Institute of Mental Health.“The Effect of a Primary Care Practice-Based Depression Intervention on Mortality in Older Adults” is posted at<www.annals.org/cgi/reprint/146/10/689.pdf>.▪ ISSUES NewArchived