GPs may reduce depression and suicidal thoughts in older people
Between five and 10 per cent of people over 60 suffer from depression - a common and disabling disorder.
In those aged over 60 in Australia about 5%, nearly 1 in every 20 will display suicidal ideation and will say that they wish to die.
It is predicted that depression will be the second leading cause of disability worldwide within the next 10 years, making it a major public health problem.
In the biggest study of depression in older people in Australia, researchers at The University of Western Australia and nationally showed that by educating GPs, it was possible to reduce the prevalence of depression, self-harm and suicidal thoughts in their older patients.
Published in the Annals of Family Medicine, the study found that a physician's empathy and willingness to discuss the emotional concerns of patients might play an important role in reducing self-harm [and suicide] thoughts and depression.
The study's chief investigator, Winthrop Professor Osvaldo Almeida at UWA's Centre for Health and Ageing, said more than 370 GPs and almost 22,000 patients took part in the two-year study.
Some of the GPs (the control group) received no structured education while others had their practice reviewed and received relevant educational material and six-monthly newsletters over the two years of the study.
"We wanted to test a more universal approach to depression treatment, one that would not be limited to older people who show overt or slight depressive symptoms," Professor Almeida said.
"The patients seen by the GPs who had received the educational intervention were less likely to display symptoms of depression or self-harming behaviour after two years than the controls. In other words, the relative number of people with these problems decreased in the intervention group.
"What caused these changes is not entirely clear, but the benefits could not be explained by more frequent use of antidepressants or greater contact with health services.
The most plausible explanation is that the GPs who received the intervention were more willing to discuss their patients' emotional concerns and that this greater openness and empathy made all the difference."
Professor Almeida said the intervention was simple and inexpensive, although replication of the results is required before the study activities can be recommended for adoption in normal clinical practice.
"Our results are exciting because they indicate that we may be able to decrease the prevalence of depression and self-harm behaviour in the community by means of targeted education of health professionals.
"They also suggest that, in some instances, the relationship between patients and physicians might be more therapeutic than the drugs they prescribe."
To hear a very interesting podcast interview "Depression and self-harm among older patients" (text also available) with Norman Swan and Professor Osvaldo Almeida on the Health Report of 30 July 2012, see http://www.abc.net.au/radionational/programs/healthreport/depression-and-self-harm-among-older-patients/4164198.
Read the full article "A Randomized Trial to Reduce the Prevalence of Depression and Self-Harm Behavior in Older Primary Care Patients" at http://www.annfammed.org/content/10/4/347.full.
If you are having depressive or self harm thoughts make the time to phone Lifeline on 13 11 14 any hour of the day or night.
17 July 2012.