OBJECTIVE: The purpose of this study was to determine treatment outcome
in elderly patients with consecutively treated episodes of recurrent
unipolar major depression. METHOD: Subjects were 32 "young" elderly
patients with recurrent unipolar depression (mean age = 66.8 years, SD =
5.1) and with two consecutively treated episodes of major depression. Both
index and subsequent episodes of major depression were treated in open
trial with combined nortriptyline and interpersonal psychotherapy. Rates of
remission in index and subsequent episodes were compared by using
nonparametric statistics and survival analysis with proportional hazards
modeling. RESULTS: Of 30 patients who completed treatment of the subsequent
episode, 27 (90%) achieved stable remission of symptoms in both
consecutively treated episodes, whereas three patients (10%) did not.
Twenty-two (81%) of 27 patients who responded to treatment had a shorter
time to remission in treatment of the subsequent episode than in the index
episode. Survival analysis with proportional hazards modeling detected a
significant difference in time to remission of the index and subsequent
episodes (32 paired observations). CONCLUSIONS: In this research study
group, recurrent episodes of unipolar major depression in the young elderly
were successfully treated to remission in over 80% of patients by using
combined pharmacotherapy and psychotherapy similar to that employed in
treatment of the index episode. Remission rate and time to remission in
consecutively treated episodes were comparable to those in a group of
midlife patients with recurrent depression reported by Kupfer et al. in
1989. Thus, recurrent depressive disorder appears to be as treatable in the
young elderly as it is in midlife patients.
Abstract Teaser