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Depression and suicidal behaviors in medicare primary care patients under age 65

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Abstract

OBJECTIVE: To examine suicidal behavior and depression prevalence among a group of Medicare patients under age 65 with functional impairment and recent significant health care services use.

DESIGN: An observational study of baseline characteristics of participants in a randomized controlled trial.

SETTING: A Medicare demonstration (N=1,605) that enrolled primary care patients in 8 counties in New York, 6 counties in West Virginia, and 5 counties in Ohio.

PATIENTS/PARTICIPANTS: All demonstration participants under age 65 (n=164). Participants were required to have impairment in at least 2 activities of daily living or 3 instrumental activities of daily living, and to have had recent significant health care use.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: The Paykel questionnaire for suicidal ideation and attempts, the Mini-international Neuropsychiatric Interview Major Depressive Episode module, and the 15-item Geriatric Depression Scale were administered at baseline; 14.8% of the patients indicated suicidal ideation during the past year, 4.9% reported a suicide attempt during that time, 25.9% indicated at least 1 lifetime suicide attempt, 34.6% had a major depressive episode in the last month, and 58.3% had clinically significant depressive symptoms during the previous week.

CONCLUSIONS: These levels of suicidal ideation and behaviors and of deprssion are far higher than those found in studies of nonelderly American adults, and may indicate the need for routine screening in this population.

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Authors and Affiliations

  1. Department of Community and Preventive Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 644, 14642, Rochester, NY

    Bruce Friedman PhD & Rachel Ritz Delavan MS

  2. Department of Psychiatry, University of Rochester, Rochester, NY, USA

    Bruce Friedman PhD & Yeates Conwell MD

  3. Center for Aging and Healthcare in West Virginia, Inc., Parkersburg, WV, USA

    Brenda R. Wamsley PhD

  4. Monroe County Long Term Care Program, Inc., Rochester, NY, USA

    Gerald M. Eggert PhD

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  1. Bruce Friedman PhD
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  2. Yeates Conwell MD
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Correspondence to Bruce Friedman PhD.

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Friedman, B., Conwell, Y., Delavan, R.R. et al. Depression and suicidal behaviors in medicare primary care patients under age 65. J GEN INTERN MED 20, 397–403 (2005). https://doi.org/10.1111/j.1525-1497.2005.40244.x

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