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Randomized Controlled Trial
. 2010 Jan;58(1):23-9.
doi: 10.1111/j.1532-5415.2009.02610.x. Epub 2009 Nov 25.

Treatment of late-life depression alleviates caregiver burden

Lynn M Martire  1 , Richard Schulz, Charles F Reynolds 3rd, Jordan F Karp, Ariel G Gildengers, Ellen M Whyte
Affiliations
Randomized Controlled Trial

Treatment of late-life depression alleviates caregiver burden

Lynn M Martire et al. J Am Geriatr Soc. 2010 Jan.

Abstract

Objectives: To describe the burden experienced by family caregivers of older adults with depression and to examine the positive effects on caregivers of treating late-life depression.

Design: Two-phase treatment study for major depressive disorder (MDD) that included 6 weeks of open treatment with antidepressant medication for all older patients followed by 16 weeks of randomized treatment for patients who were partial responders, comparing a combination of medication and interpersonal psychotherapy with medication alone.

Setting: Primary care and university late-life mental health research clinic.

Participants: Adults aged 60 and older participating in a randomized trial for treatment of MDD who enrolled in a family caregiver study and their caregiver (N=244 dyads).

Measurements: Improvement in patient symptoms during open treatment (lower scores on the Hamilton Rating Scale for Depression (HRSD)) and remission of depression during randomized treatment (3 consecutive weekly HRSD scores of < or =7) were examined as predictors of lower general caregiver burden and burden specific to patient depression.

Results: Caregivers reported a moderate to high level of general caregiver burden on average. Change in patient depression during open treatment was associated with significantly decreased depression-specific burden (beta=-0.22, P=.001) and a trend toward lower general burden (beta=-0.08, P=.08). Caregivers of patients who remitted showed significantly decreased depression-specific burden (F (1,76)=4.27, P=.04).

Conclusion: Treatment of late-life depression has benefits that extend to the family members on whom patients depend. Caregiver education and support may strengthen these effects.

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Conflict of interest statement

Conflict of Interest: Dr. Reynolds receives research support in the form of pharmaceutical supplies for his National Institutes of Health (NIH)–sponsored research from GlaxoSmithKline, Forest Laboratories, Pfizer, Lilly, Bristol Meyers Squibb, and Wyeth. Dr. Karp receives medication supplies from Eli Lilly for his NIH-sponsored research, is an adviser to Lilly, owns stock in Corcept, and has received honoraria for unrestricted educational activity from Novartis and Pfizer. Dr. Gildengers receives research support for an investigator-initiated trial for GlaxoSmithKline. Dr. Whyte has received research support for investigator-initiated trials for Pfizer, Forrest, Ortho-McNeil, and Lilly.

Figures

Figure 1
Figure 1
Flow chart for participation in caregiver study.
Figure 2
Figure 2
Patient remission status × time interaction for depression-specific caregiver burden. Dashed line = patient remitted (3 consecutive weekly scores of ≤7 on the Hamilton Rating Scale for Depression). Solid line = patient did not remit.
See this image and copyright information in PMC

References

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    1. Lenze EJ, Dew MA, Mazumdar S, et al. Combined pharmacotherapy and psychotherapy as maintenance treatment for late-life depression: Effects on social adjustment. Am J Psychiatry. 2002;159:466–468. - PubMed

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