Abstract
Objective: Comorbid anxiety disorders may result in worse depression treatment outcomes. The authors evaluated the effect of comorbidpanic disorder andposttraumatic stress disorder (PTSD) on response to a collaborative-care intervention for late-life depression in primary care. Methods: A total of 1,801 older adults with depression were randomized to a collaborative-care depression treatment model versus usual care and assessed at baseline, 3, 6, and 12 months, comparing differences among participants with comorbid panic disorder (N = 262) and PTSD (N = 191) and those without such comorbid anxiety disorders. Results: At baseline, patients with comorbid anxiety reported higher levels of psychiatric and medical illness, greater functional impairment, and lower quality of life. Participants without comorbid anxiety who received collaborative care had early and lasting improvements in depression compared with those in usual care. Participants with comorbid panic disorder showed similar outcomes, whereas those with comorbid PTSD showed a more delayed response, requiring 12 months of intervention to show a significant effect. At 12 months, however, outcomes were comparable. Interactions of intervention status by comorbid PTSD or panic disorder were not statistically significant, suggesting that the collaborative-care model performed significantly better than usual care in depressed older adults both with and without comorbid anxiety. Conclusions: Collaborative care is more effective than usual care for depressed older adults with and without comorbid panic disorder and PTSD, although a sustained treatment response was slower to emerge for participants with PTSD. Intensive and prolonged follow-up may be needed for depressed older adults with comorbid PTSD.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 48-58 |
| Number of pages | 11 |
| Journal | American Journal of Geriatric Psychiatry |
| Volume | 13 |
| Issue number | 1 |
| DOIs | |
| State | Published - 2005 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Psychiatry and Mental health
- Geriatrics and Gerontology
Cite this
Impact of comorbid panic and posttraumatic stress disorder on outcomes of collaborative care for late-life depression in primary care. / Hegel, Mark T.; Unützer, Jürgen; Tang, Lingqi; Areán, Patricia A.; Katon, Wayne; Noel, Polly H; Williams, John W.; Lin, Elizabeth H B.
In: American Journal of Geriatric Psychiatry, Vol. 13, No. 1, 2005, p. 48-58.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impact of comorbid panic and posttraumatic stress disorder on outcomes of collaborative care for late-life depression in primary care
AU - Hegel, Mark T.
AU - Unützer, Jürgen
AU - Tang, Lingqi
AU - Areán, Patricia A.
AU - Katon, Wayne
AU - Noel, Polly H
AU - Williams, John W.
AU - Lin, Elizabeth H B
PY - 2005
Y1 - 2005
N2 - Objective: Comorbid anxiety disorders may result in worse depression treatment outcomes. The authors evaluated the effect of comorbidpanic disorder andposttraumatic stress disorder (PTSD) on response to a collaborative-care intervention for late-life depression in primary care. Methods: A total of 1,801 older adults with depression were randomized to a collaborative-care depression treatment model versus usual care and assessed at baseline, 3, 6, and 12 months, comparing differences among participants with comorbid panic disorder (N = 262) and PTSD (N = 191) and those without such comorbid anxiety disorders. Results: At baseline, patients with comorbid anxiety reported higher levels of psychiatric and medical illness, greater functional impairment, and lower quality of life. Participants without comorbid anxiety who received collaborative care had early and lasting improvements in depression compared with those in usual care. Participants with comorbid panic disorder showed similar outcomes, whereas those with comorbid PTSD showed a more delayed response, requiring 12 months of intervention to show a significant effect. At 12 months, however, outcomes were comparable. Interactions of intervention status by comorbid PTSD or panic disorder were not statistically significant, suggesting that the collaborative-care model performed significantly better than usual care in depressed older adults both with and without comorbid anxiety. Conclusions: Collaborative care is more effective than usual care for depressed older adults with and without comorbid panic disorder and PTSD, although a sustained treatment response was slower to emerge for participants with PTSD. Intensive and prolonged follow-up may be needed for depressed older adults with comorbid PTSD.
AB - Objective: Comorbid anxiety disorders may result in worse depression treatment outcomes. The authors evaluated the effect of comorbidpanic disorder andposttraumatic stress disorder (PTSD) on response to a collaborative-care intervention for late-life depression in primary care. Methods: A total of 1,801 older adults with depression were randomized to a collaborative-care depression treatment model versus usual care and assessed at baseline, 3, 6, and 12 months, comparing differences among participants with comorbid panic disorder (N = 262) and PTSD (N = 191) and those without such comorbid anxiety disorders. Results: At baseline, patients with comorbid anxiety reported higher levels of psychiatric and medical illness, greater functional impairment, and lower quality of life. Participants without comorbid anxiety who received collaborative care had early and lasting improvements in depression compared with those in usual care. Participants with comorbid panic disorder showed similar outcomes, whereas those with comorbid PTSD showed a more delayed response, requiring 12 months of intervention to show a significant effect. At 12 months, however, outcomes were comparable. Interactions of intervention status by comorbid PTSD or panic disorder were not statistically significant, suggesting that the collaborative-care model performed significantly better than usual care in depressed older adults both with and without comorbid anxiety. Conclusions: Collaborative care is more effective than usual care for depressed older adults with and without comorbid panic disorder and PTSD, although a sustained treatment response was slower to emerge for participants with PTSD. Intensive and prolonged follow-up may be needed for depressed older adults with comorbid PTSD.
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UR - http://www.scopus.com/inward/citedby.url?scp=16844368226&partnerID=8YFLogxK
U2 - 10.1097/00019442-200501000-00008
DO - 10.1097/00019442-200501000-00008
M3 - Article
C2 - 15653940
AN - SCOPUS:16844368226
VL - 13
SP - 48
EP - 58
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
SN - 1064-7481
IS - 1
ER -