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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 1/2013

01-01-2013 | Original Paper

Social inequalities in depression and suicidal ideation among older primary care patients

Authors: Stephen E. Gilman, Martha L. Bruce, Thomas Ten Have, George S. Alexopoulos, Benoit H. Mulsant, Charles F. Reynolds III, Alex Cohen

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 1/2013

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Abstract

Purpose

Depression and suicide are major public health concerns, and are often unrecognized among the elderly. This study investigated social inequalities in depressive symptoms and suicidal ideation among older adults.

Methods

Data come from 1,226 participants in PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial), a large primary care-based intervention trial for late-life depression. Linear and logistic regressions were used to analyze depressive symptoms and suicidal ideation over the 2-year follow-up period.

Results

Mean Hamilton Depression Rating Scale (HDRS) scores were significantly higher among participants in financial strain [regression coefficient (b) = 1.78, 95 % confidence interval (CI) = 0.67–2.89] and with annual incomes below $20,000 (b = 1.67, CI = 0.34–3.00). Financial strain was also associated with a higher risk of suicidal ideation (odds ratio = 2.35, CI = 1.38–3.98).

Conclusions

There exist marked social inequalities in depressive symptoms and suicidal ideation among older adults attending primary care practices, the setting in which depression is most commonly treated. Our results justify continued efforts to understand the mechanisms generating such inequalities and to recognize and provide effective treatments for depression among high-risk populations.
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Metadata
Title
Social inequalities in depression and suicidal ideation among older primary care patients
Authors
Stephen E. Gilman
Martha L. Bruce
Thomas Ten Have
George S. Alexopoulos
Benoit H. Mulsant
Charles F. Reynolds III
Alex Cohen
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 1/2013
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-012-0575-9

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