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Depressed Seniors in Primary Care Benefit Most From Team Approach

studies that incorporated interdisciplinary teams, in which mental health providers worked in collaboration with medical providers to develop plans for care. These models resulted in “consistently significant improvements in depressive symptoms,” the reviewers found.

The reviewers note that they could not combine results across the studies, because of large variations in study populations, interventions and providers involved. Clear guidelines for future projects are a must, said Skultety, so that results can be compared and combined to reveal the most effective treatments.

Furthermore, she said, all future studies need to report the number of patients who drop out of each treatment program. “Just showing that [a treatment] works isn’t quite enough. You also have to show that you can actually get people to stay engaged in it over time.”

“Even at this point I think there’s enough evidence to say this is a desired model if you’re going to work in primary care,” said Forrest Scogin, president-elect of the Clinical Geropsychology Section of the American Psychological Association.

Interdisciplinary teams have become commonplace in treating diabetes and other chronic conditions, Scogin said. “You’re involving more professionals in the treatment, so really it becomes more of a fiscal issue.”

While Skultety said that involving interdisciplinary teams can be time-consuming initially, she added “You’re actually looking at saving yourself time down the road because you’re addressing everything at once. Otherwise, a lot of older adults present depression with just vague physical complaints, and they come back again and again and again.”

Estimates of depressive symptoms among older adults in community and primary care settings range from 10 percent to 25 percent, say the authors. Depression exacerbates physical health problems in seniors and vice versa.
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