Persons with severe mental illness have a life expectancy about 25 years less than
others, largely due to preventable diseases.
1
What has perhaps received less attention until recently has been the increased mortality
rate of persons with depression even when symptoms are relatively mild
2
,
3
,
4
or when constructs that map to depression but are not strictly a component of standard
criteria are studied (e.g., hopelessness, pessimism).
5
Suicide does not account for the increased mortality: The vast majority of older
persons with depression die of cardiovascular disease and other medical conditions.
Depression acts through psychological, social, and behavioral mechanisms to increase
mortality (e.g., depressed patients are less likely to adhere to treatment regimens
for cardiac disease or diabetes), and may also have direct effects on biological processes
such as inflammation.
6
Research in recent decades has increased the realization that the connection between
depression and medical conditions like diabetes and cardiovascular disease poses a
significant challenge for clinical and public health, particularly in an aging society.To read this article in full you will need to make a payment
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References
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- Prevention of post-stroke mortality using problem solving therapy or escitalopram.Am J Geriatr Psychiatry. 2017; 25: 512-519
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Article info
Publication history
Published online: February 10, 2017
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© 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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- Prevention of Poststroke Mortality Using Problem-Solving Therapy or EscitalopramThe American Journal of Geriatric PsychiatryVol. 25Issue 5
- PreviewThis study re-examined patients from a 1-year randomized controlled double-blind trial of escitalopram, problem-solving therapy (PST), or placebo to prevent depression among patients less than 3 months after a stroke. The objective of the current study was to determine if preventive treatment would predict time to death over 8–10 years of follow-up. Based on the importance of depression in poststoke mortality and a previous study of this population at 18 months' follow-up showing that stopping escitalopram but not PST led to a significant increase in depression, the authors hypothesized that PST would be associated with the longest time to death.
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