NIMH Grant Funds Research on Depression in Elderly
April 02, 2001
The National Institute of Mental Health has awarded $2.74 million to University of Rochester Medical Center psychiatrists studying a problem that affects one in five adults over the age of 65 in the Rochester area: depression. The latest grant brings to $9 million the amount of funding attracted by the Department of Psychiatry since last summer.
Jeffrey M. Lyness, M.D., associate professor of psychiatry and director of the Program in Geriatrics and Neuropsychiatry, will lead the study of 1,000 individuals, one of the largest studies of depression ever done in the Rochester area. Past studies by Lyness and others have shown that more than 20 percent of adults over the age of 65 who visit doctors are clinically depressed. Some patients will improve on their own, while others will worsen. It's likely that fewer than half will receive treatment.
"Recognition of depression in the elderly is growing," says Lyness. "Older people are less likely to think of themselves as depressed; they're more likely to think that feeling down or losing interest in activities should be expected as they become older or disabled. Actually, they have an illness which, as a physician, is a very rewarding condition to treat. Oftentimes a patient will say, 'Wow, I didn't know I could feel this good.'"
Elderly people are less likely than younger people to use the word "depressed" to describe how they feel, Lyness says. Instead, they may say they're less interested in activities than they once were, they may find it hard to get through the day, or they may just not "feel themselves" and begin to give up social activities. When it's treated, more than 80 percent of patients with depression feel better; treatments might include counseling, medication, or helping patients reconnect with family and friends.
Lyness will study the relationship between depression and other illnesses, to try and identify those patients at highest risk for developing chronic depression and to learn how to better treat their illness. Illness and disability, such as a history of heart disease or stroke, may predispose patients to depression. The team will also study the roles of personality traits, social support, religious belief and practices, and other life events such as the death of a loved one.
While most studies of depression focus on people who have already been referred by primary care doctors to psychiatrists, this study will focus on people who are seeing their primary care doctors for other reasons. Lyness' team will rely on its contacts with primary care doctors to find patients for the study.
Lyness' study is one of several in the Department of Psychiatry to be funded recently. Other projects recently funded include:
- Suicide prevention. Eric Caine, M.D., and colleagues will put together a series of national meetings bringing together experts in the field of suicide prevention. Researchers will review current efforts, develop a consensus of best practices, and discuss future research initiatives to reduce suicide and suicidal behavior.
- Alcoholism and suicide risk. While alcoholism is a risk factor for suicide, most alcoholics do not commit suicide. Kenneth Conner, Psy.D., will search for factors that distinguish those at high risk.
- Depression and suicide. Paul Duberstein, Ph.D., leads a team that is searching for ways to identify people who are depressed, part of an effort to reduce the number of people who commit suicide.
- Depression and sleep. Donna Giles, Ph.D., is studying how sleep patterns that are passed from parents to children sometimes indicate a greater likelihood for depression throughout life. Giles is following up on findings that show that sleep patterns sometimes can be used to predict who will get depressed in the future. Giles, who has followed the sleep and mood patterns of 70 families for more than 15 years, will also compare the timing of the onset of depression between parents and their children.
- Sleeping pills. A team led by Michael Perlis, Ph.D., will study the safety and effectiveness of sleeping pills when they're used intermittently for a long time. Some people who have chronic insomnia use sleeping pills much longer than the few weeks recommended by the Food and Drug Administration.
- Insomnia. Perlis is studying an unusual type of brain activity that occurs in people with insomnia, a kind of "wakefulness" that occurs in the brains of people with insomnia as they sleep.
- Weight gain and treatment. Weight gain is often cited by patients as the biggest side effect of certain anti-psychotic drugs. Karen Wiener, M.D., is studying the possible use of the drug amantadine to ease this problem in patients taking olanzapine for shizophrenia and bipolar disorder.
- Medications and schizophrenia. As part of a large national study, University of Rochester researchers led by J. Steven Lamberti, M.D., are comparing the effectiveness of several antipsychotic medications in patients with schizophrenia. Marvin Herz, M.D., will participate in a study to test a new compound, aripiprazole, to treat patients with schizophrenia who have not responded to conventional medications.
- Safety of health-care professionals. Robert L. Weisman, D.O., is leading an effort to teach health care providers the skills they need to identify potentially dangerous clinical situations in outpatient settings, and to respond safely. The Safety and Violence Education (SAVE) curriculum will be implemented in several clinical sites in Monroe County.