depression, antidepressant use and mortality in later life the health in men study抑郁症,抗抑郁药物使用和死亡率在晚年健康男性的研究.pdfVIP

Depression, Antidepressant Use and Mortality in Later Life: The Health in Men Study Osvaldo P. Almeida1,2,3*, Helman Alfonso1,2, Graeme J. Hankey4,5, Leon Flicker1,5,6 1 Western Australia Centre for Health Ageing, Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia, 2 School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia, 3 Department of Psychiatry, Royal Perth Hospital, Perth, Western Australia, Australia, 4 Stroke Unit, Royal Perth Hospital, Perth, Western Australia, Australia, 5 School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia, 6 Department of Geriatric Medicine, Royal Perth Hospital, Perth, Western Australia, Australia Abstract Context: Depression is associated with increased mortality, but it is unclear if this relationship is dose-dependent and if it can be modified by treatment with antidepressants. Objective: To determine if (1) the association between depression and mortality is independent of other common potential causes of death in later life, (2) there is a dose-response relationship between increasing severity of depression and mortality rates, and (3) the use of antidepressant drugs reduces mortality rates. Methods: Cohort study of 5,276 community-dwelling men aged 68–88 years living in Perth, Australia. We used the Geriatric Depression Scale 15-items (GDS-15) to ascertain the presence and severity of depression. GDS-15$7 indicates the presence of clinically significant depression. Men were also grouped according to the severity of symptoms: ‘‘no symptoms’’ (GDS- 15 = 0), ‘‘questionable’’ (1#GDS-15#4), ‘‘mild to moderate’’ (5#GDS-15#9), and ‘‘severe’’ (GDS-15$10). Participants listed all medications used regularly. We used the Western Australian Data Linkage System to monitor mortality. Res