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A new article entitled, Course of Depression and Mortality Among Older Primary Care Patients in the American Journal of Geriatric Psychiatry by Bogner, Morales, Reynolds, Cary, and Bruce presents a study examining the course of depression severity among older primary care patients and its association with mortality. Data were obtained from a large randomized controlled trial involving 20 primary care practices. The Hamilton Depression Rating Scale (HDRS) and the Centers for Epidemiologic Studies Depression scale (CES-D) were used to measure depression. The authors used growth curve mixture modeling to identify latent classescharacterized by the course of depressive symptoms across 12 months. Survival analysis was used to relate these clusters to mortality status at 5 years. Among 599 participants, 114 were deceased at follow-up. The authors found that three patterns best fit the data: one with persistent depressive symptoms, high but declining symptoms, and low and declining symptoms. The authors reported that patients in the persistent depressive symptoms cluster were 69.88% more likely to reach death sooner than the other clusters controlling for age, smoking status, and comorbidity. The authors use these data to emphasize the implications for both empowering primary care providers to treat psychological problems and facilitating improved co-management of psychological disorders among primary care providers and mental health professionals.

We invite you to post comments/suggestions on how to enhance the capacity for primary care providers to (a) identify mental health problems and make informed referrals, (b) treat mental health problems that are inside the practice’s resources, and (c) to effectively communicate with mental health professionals towards co-managing patient symptoms.

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