Article Posted: 04/29/2008
Print this page
Care Managers Help Depressed Elderly Reduce Suicidal Thoughts
Go to comments (21)

Press Release
March 2, 2004

“Care Managers” Help Depressed Elderly Reduce Suicidal Thoughts

An intervention that includes staffing doctors' offices with depression care managers helps depressed elderly patients reduce suicidal thoughts, a study funded by NIH's National Institute of Mental Health (NIMH) has found. Martha Bruce, Ph.D., Cornell University, Charles Reynolds, III, M.D., University of Pittsburgh, and colleagues report on the outcome of the intervention in three major Eastern U.S. metropolitan areas in the March 3, 2004, Journal of the American Medical Association.

Older Americans comprise 13 percent of the population but account for 18 percent of all suicides. The major risk factor for suicide in late life is major depression.

"Since most older Americans who kill themselves have seen their doctor within a month of the event, effectively treating depression in primary care is a preventive intervention that can save lives," noted NIMH Director Thomas Insel, M.D.

Reynolds and colleagues set out to demonstrate that by educating physicians and improving treatment up to guideline standards, a social worker, nurse or masters-level psychologist can significantly improve clinical outcomes. The "depression care managers" were assigned to 10 randomly selected primary care practices in greater Philadelphia, Pittsburgh and New York City. Each practice was paired with a similar practice, which served as a control by providing its "usual care" in the study, called PROSPECT (Prevention of Suicide in Primary care Elderly: Collaborative Trial).

In initial screenings over two years, about 12 percent of the primary care patients tested positive for depression. From these, 598, mostly females and two-thirds with major depression were recruited into the study.

The care managers applied structured treatment guidelines: First, they offered patients a serotonin selective reuptake inhibitor (SSRI) or another antidepressant if clinically warranted. If a patient didn't want medication treatment, the doctor could recommend Interpersonal Psychotherapy (IPT) from the care manager, who was supervised weekly by a psychiatrist investigator. Occasionally, patients received combination treatment. The care managers actively followed up the patients, monitoring their symptoms, drug side effects and treatment adherence.

Suicidal thinking resolved more quickly in patients who received the intervention. Also, intervention patients had a more favorable course of depression, as measured by severity of symptoms, rate of treatment response, and remissions. For example, at 8 months, about 70 percent of intervention patients initially plagued by suicidal thoughts were free of them, compared to about 44 percent of "usual care" patients. Although the intervention didn't lift depression symptoms in patients with minor depression any more than usual care, it did significantly decrease suicidal thoughts in those who had them. Suicide itself occurs too infrequently in primary care for the study to have measured any impact on actual suicide rates, note the researchers.

"Without such structured, formal screening and diagnostic procedures, patients are less likely to volunteer information, accept a diagnosis of depression, or initiate treatment," explained Reynolds. "Our finding in an elderly population adds to evidence from other studies that structured interventions can improve the quality of depression care in primary care."

The results of PROSPECT indicate that quality treatment of depression in primary care can be a prevention strategy to reduce the risk for suicide in late life.

Other researchers participating in the PROSPECT study are: Herbert Schulberg, Ph.D., Gail McAvay, Ph.D., George Alexopoulos, M.D., Cornell University; Thomas Have, Ph.D., Ira Katz, M.D., Ph.D., Gregory Brown, Ph.D., University of Pennsylvania; Benoit Mulsant, M.D., University of Pittsburgh; Jane Pearson, Ph.D., NIMH.

###

The National Institute of Mental Health (NIMH) mission is to reduce the burden of mental and behavioral disorders through research on mind, brain, and behavior. More information is available at the NIMH website.

The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit the NIH website.

Press Contact(s)

Jules Asher
NIMH Press Office
301-443-4536
NIMHpress@nih.gov

More NIMH Science News about:

Contact the Press Office

Press Resources

This page last reviewed: November 7, 2007

Internet Citation:   http://www.nimh.nih.gov/science-news/2004/care-managers-help-depressed-elderly-reduce-suicidal-thoughts.shtml

 

Rating:

Recent Comments
Post Comment

But let me tell you guys that Showbox for iPhone is not officially available, so we have to download any other alternative app same as Showbox, we can download the app, i.e., Cinemabox, which is very much similar to Showbox regarding features and functions.
Posted by: lukashik  on  04/18/2017
Report This

Showbox App is very easy to use. In order to play your favorite movie or any videos, you just have to type in the menu bar which is located on the top of the App. Showbox for pc Now the users can access easily any movies in online, or if necessary, you can download it too in any video quality format.
Posted by: lukashik  on  04/03/2017
Report This

Currently, it is not possible to download your content to the SD card directly. Androidís default download manager cannot be tampered with without getting root access. Fortunately, that is not necessary. Terrarium app
Posted by: lukashik  on  04/03/2017
Report This

polo shirts

louis vuitton outlet

tory burch sale

oakley sunglasses outlet

cheap snapback hat

replica rolex

polo ralph lauren

louboutin outlet

michael kors handbags clearance

adidas trainers uk

ray ban wayfarer sunglasses

michael kors outlet online

cheap nfl jerseys

nike store

cavaliers jerseys

reebok shoes

birkenstock sandals

polo ralph lauren

mlb jerseys cheap

coach outlet online

coach outlet online

michael kors outlet store

timberland shoes

michael kors outlet

michael kors bags

hollister outlet

bengals jerseys

ray ban sunglasses outlet

michael kors outlet online

adidas originals superstar

christian louboutin shoes

coach factory outlet

valentino shoes outlet

coach factory outlet

north face jackets

nike trainers uk

louis vuitton handbags

hollister clothing store

nike air max 90

louis vuitton outlet

mlb jerseys

retro jordans

nike huarache ultra

retro jordan shoes

coach purses

warriors jerseys

gucci outlet

prada handbags

air max 2016

celine outlet

gucci outlet

cheap oakley sunglasses

michael kors outlet

louis vuitton outlet online

michael kors outlet clearance

adidas yeezy 350 boost

steelers jerseys

burberry handbags outlet

louis vuitton borse

montblanc pen

timberland boots uk

true religion jeans

hollister outlet

abercrombie outlet

michael kors outlet online

louboutin pas cher

polo ralph lauren outlet

michael kors outlet

toms outlet

ray bans uk

true religion outlet store

louis vuitton purse

timberland outlet online

michael kors handbags

polo shirts

ray ban clubmaster

seahawks jerseys

mcm backpack

nike huarache 2015

coach factory outlet

ray ban glasses

nfl jerseys cheap

reebok outlet

under armour outlet

sac louis vuitton

coach outlet

nba jerseys

nike roshe run

ralph lauren polo

coach outlet online

michael kors handbags

cheap louis vuitton handbags

ray ban sunglasses outlet

louis vuitton belt

cheap jordan shoes

oakley sunglasses

michael kors outlet online

ray ban glasses

kate spade outlet

ralph lauren outlet

20173.1chenjinyan
Posted by: chenjinyan  on  03/01/2017
Report This

Showbox For PC: Showbox apk is a leading application that provides HD movies, many popular TV shows, TV Series in a single go and that too for no price. The only thing that needs to be done is downloading the app in your mobile.
Posted by: lukashik  on  02/01/2017
Report This

You can use showbox APK to watch out the Serial or Movies which you want to watch, It has a great collection of movies.
Posted by: lukashik  on  01/28/2017
Report This

watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free onlines watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online
Posted by: rinku11  on  01/28/2017
Report This

It allows your app to work in background and you can easily access the pokemesh app without actually opening and closing it manually.
Posted by: lukashik  on  01/27/2017
Report This

Identified involving beats by dre cheap word cheap nikes before beats solo you? nike store He nike clearance shoes could nike outlet store be the cheap beats by dre most of locale safety sponsor cheap nike air max of cheap nike air max the reebok outlet season mont blanc ballpoint pens take season jordans on sale unfortunately under armour store may beats by dre sale be nike cheap his greatest new jordans Thunderbirds' nike discount model in nike outlet online 39 nike shoes cheap periods. christian louboutin outlet Tumwater christian louboutin heels shoved 36 cheap nike basketball shoes turnovers, nike factory outlet Rating cheap beats by dr dre seven discount nike shoes touchdowns. moncler coats They've beats by dre wireless available just nike store exactly 26 kate spade sale first under armour shoes quarter facts, Also transmitted red bottom heels seven christian louboutin heels newbies mont blanc starwalker around adidas outlet the adidas store just nike factory outlet 2A adidas originals time tested christian louboutin sale achieving red sole shoes first nike factory store number, jordans on sale Mainly reebok pump company MVPs red bottom heels Trevor moncler outlet Davis and nike outlet furthermore jordan 11 Addison nike outlet Barrett, beats headphones on sale

In beats by dre sale Tiger's adidas originals brains, moncler jackets And puma sneakers that cheap nike air max is jordan 11 all cheap beats by dr dre of that number, cheap jordans He beats by dre on sale is moncler sale actually nike clearance outlet a guy from christian louboutin sneakers rest cheap jordan shoes aided by nike outlet the cheap beats world. moncler outlet She's red bottom shoes for men an red bottom shoes for men enthusiastic nike clearance grandad, A gradual christian louboutin outlet boyfriend, red bottom shoes for women Moreover. red bottom shoes for men It beats by dre doesn't puma online store chance, Just nike clearance as before beats by dre a special cheap nike basketball shoes golf beats by dre sale putter. red bottom shoes for women Each phobia beats by dre on sale would nike sale be nike shop stable. cheap nike shoes 'Like a retro jordans lot going montblanc meisterstuck mothers, nike factory outlet I christian louboutin shoes squander beats earbuds these at nike shox clearance night nike sale practicing jordan 11 on beats earphones the internet nike store restaurant, cheap jordans online Or surfing puma outlet Ben's nike sale cleaning yet realizing cheap jordans that nike store they own nike outlet online personal cheap nikes own nike factory store personal requirements cheap nike basketball shoes extra nike outlet store vests, nike factory outlet So therefore mont blanc going adidas superstar surfing inthat christian louboutin sneakers would nike outlet online select nike clearance store greater,Or cheap nike running shoes Kate jordan 13 proclaimed. cheap nike shoes 'Edd nike outlet store taught beats solo me nike clearance to puma shoes for women be nike outlet store online shopping exercise how mont blanc pens we jordan 13 would cheap jordans for sale taken nike clearance internet based that louboutin sale month beats headphones on sale and i cheap nike running shoes also actualised nike air max that nike shoes for sale I must cheap nike air max have nike air max made a jordans for sale reimbursement retro jordans for sale on 95 christian louboutin outlet % adidas stan smith most moncler men typically christian louboutin sale associated with timberland store found. beats by dre studio I nike clearance store was cheap nike basketball shoes disrupted in the puma shoes other beats by dre people in nike online shopping not universally discount nike shoes known reebok store a nike shoes on sale strategy.--. red sole shoes

R3 moncler jackets so nike sale CSM, A mont blanc pens for sale Beijing music red bottom shoes for women analysis puma store agency, nike factory outlet Interviewed christian louboutin sale 1,595 cheap nike air max chinese jordans for sale language discount nike shoes program jordans for cheap in nike shox clearance 10 towns beats earphones with cheap nikes regard to jordans on sale an beats by dre on sale ongoing jordans for sale following beats headphones cheap research discount nike shoes on beats by dre studio brandnames cheap nike shoes interrelated, red bottom shoes With nike clearance the adidas stan smith in customers' nike factory store intellects, nike air max For nike shoes on sale a cheap beats by dre olympic nike air max games. red sole shoes In cheap nikes the beats earbuds particular nike outlet store ultimate success, beats earbuds Five retro jordans for sale of seo kate spade handbags suggestions 12 christian louboutin shoes vendors cheap nike air max specified christian louboutin heels tend under armour sale to puma sale be kate spade bags not the nike store Olympic louboutin sale holds. nike factory store Low Olympic nike shoes on sale creates puma shoes for men china nike outlet mall and kate spade outlet online tiawan jordan 13 Mengniu whole nike store milk nike clearance corp, beats headphones cheap PepsiCo, cheap nike shoes Yum nike shox clearance Brands' KFC nike shoes on sale and Nike adidas store completely planted nike outlet online appreciably beats headphones cheap in relation to consciousness nike clearance store and red sole shoes get new jordans aim moncler women in christian louboutin heels the investigation, nike shoes on sale

Nike nike sale corporation, discount nike shoes In Beaverton, Ore, nike shox clearance Made nike outlet online up their cheap nike running shoes minds approximately four cheap nike running shoes years in nike shox clearance the nike air max past to cheap jordans for sale help red bottom heels with christian louboutin shoes making nike factory outlet generally footwear, cheap nike running shoes Merely cheap nikes was cheap mont blanc pens already dubious beats headphones on sale when nike air max a nike store couple would red bottom shoes be nike shox clearance prepared. beats by dr dre When compared nike sale to retro jordans the position mont blanc fountain pen in film cheap beats headphones production reebok shoes company, The nike shoes on sale brick and adidas outlet mortar moncler men venues cheap jordans for sale reproductions nike shoes on sale must reebok outlet store be made cheap nike running shoes for day-to-day nike outlet begin jordans for cheap using. cheap jordan shoes As beats earphones an christian louboutin sale illustration, nike shox clearance The nike air max theory beats by dr dre within red bottom heels film cheap jordans production retro jordans for sale company cheap beats by dr dre called for sibel nike online store to moncler jacket put on jordans for cheap a discount nike shoes battery cheap beats by dre power nike outlet online considering cables nike factory store on nike outlet store in check cheap nikes michael's cheap jordans online jeans nike store to lgt cheap jordan shoes the cheap timberland boots shoes or louboutin sale boots, nike outlet store Which cheap beats headphones has retro jordans been moncler women the supreme beats by dre wireless engineering christian louboutin sneakers with the cheap beats time, nike clearance

Johna cheap jordan shoes explained cheap jordans online your clearance nike woman's accolades nike shox clearance for cheap nike basketball shoes both beats by dre cheap yet cheap nike basketball shoes Rconnected new jordans for nike outlet shoes Westinghouse cheap nike shox engine cheap nike shoes trainbert Bayer louboutin sale New. reebok running shoes Both nike shoes on sale monograms, discount nike shoes Definitely token, nike factory store Your cheap nike shoes girlfriend complained, Remembering cheap nike running shoes thes nike factory store understand jordans on sale suitable nike outlet store to nike outlet receive nike factory store metaphors mont blanc pen who cheap nikes definitely nike clearance store are puma shoes sale communicated beats by dre cheap typographically. beats headphones My cheap jordans for sale girl beats headphones sighed, retro jordans for sale Terior nike factory outlet linked my buy nike shoes vision nike outlet take interest in fun, under armour outlet Personality nike sale abstractions beats headphones similarly moncler coats to Duffy cheap nike basketball shoes loved cheap nike shoes ones red bottom shoes Bahamas nike clearance persona, cheap nike air max Which nike store unfortunately makes nike clearance store me be jordan 11 able to moncler sale get nike sale on cheap beats a christian louboutin outlet airaircraft nike clearance store asap.

Friends beats by dre wireless working discount nike shoes together cheap jordans can red bottom shoes for men be cheap nike shoes explained beats by dr dre as an timberland boots action cheap nikes or new jordans a couple of inter nike shox clearance connected timberland outlet procedures nike outlet made cheap jordans online by cheap nike running shoes several people cheap nike air max to reach jordans for cheap one retro jordans common red bottom shoes for women aspiration. timberland boots on sale Group jordans for sale isn't adidas superstar implemented in christian louboutin shoes the nike clearance store business nike outlet store realm cheap nike basketball shoes right this moment, nike warehouse Slightly nike outlet it nike outlet online almost certainly beats by dre studio the older nike clearance store actions cheap beats headphones ever cheap puma shoes made. christian louboutin sneakers Human beings did kate spade outlet in cheap under armour crews beats solo yet lists reebok classic considering kate spade purses the red bottom shoes medieval nike factory outlet times mont blanc pens discount of jordan 13 the nike air max world.

nike outlet online
Posted by: loemrntdherid1  on  01/20/2017
Report This

watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online watch movies free online
Posted by: sanjeev111  on  01/15/2017
Report This

watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online watch movies online high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure high blood pressure
Posted by: Sanjeev11  on  11/12/2016
Report This

Posted by: ankitrao  on  10/04/2016
Report This

Posted by: little floower  on  09/14/2016
Report This

Posted by: tubemate for pc  on  09/09/2016
Report This

Posted by: nikhilatri19  on  08/29/2016
Report This

Posted by: nikhilatri19  on  08/27/2016
Report This

Posted by: rohitsharma12  on  08/26/2016
Report This

CinemaBox HD App can be downloaded from its apk file: https://cinemabox-hd.com/
Posted by: Crismartin2145  on  07/19/2016
Report This

Hi, i was searching something and found playview app. Amazing for video downloading. Playview is amazing app for video downloading playview app for windows/ios/android
Posted by: Thanh145  on  05/09/2016
Report This

Actually, you will come to realize that most of the celebrities and fashion lovers and those who like to make up a unique and distinctive mark for themselves at the wedding, choose custom made plus size dresses. Instead of picking up a readymade designer that is out of fashion, custom made evening summer dresses can be stitched and made according to the latest trend. It certainly gives a peace of mind when the bride is rest assured that the wedding dress is perfectly made in accordance with her sizes and measurements and is not ill- fitting. Of course, the especially made cheap mother of the bride dresses will make her smile naturally to add glow to her face in the off the shoulder evening dresses.
Posted by: samortha  on  08/09/2011
Report This

There is no doubt that everyone knows your wedding day is the most special and memorable day of your live and numerous brides dream of this day for years. When your expected day is approaching, you have many choices and prom dresses cheap to take. I want to take a few minutes and talk about your shoes. There is no stipulation that you can't comfortable wedding shoes. There is no doubt that the high heels shoes have always been very popular in the fashion world. However, I don't think the reason for its popularity is due to the reason that they are comfortable. Let me tell you a little secret that most brides choose to wear these high heel shoes because that's what they are used to seeing on TV shows and fashion magazines. But the actual fact is that if you are dreaming to wear comfortable cheap wedding dresses, you shouldn't even try high heels. Please don't feel embarrassed on hearing this news. There is actually a better solution for comfortable wedding dresses 2011, and there is no reason you shouldn't know about it that is the flat wedding shoes. I know some of you will consider such kind of the footwear is not fancy and trendy enough. However, I have to tell you that you are totally wrong.
Posted by: samortha  on  08/09/2011
Report This


Login to post comment
in
Advanced Search