Reducing Suicidal Ideation and Depressive Symptoms in Depressed Older Primary Care Patients: a Randomized Controlled Trial

This study explored the effect of a primary care intervention on suicide ideation & depression in older patients. A randomized controlled trial, PROSPECT, included patient recruitment from 20 primary care practices from May 1999 through August 2001. Treatment guidelines were tailored for the elderly with care management compared to treatment as usual. Assessment of suicide ideation & depression severity was done at baseline, 4 months, 8 months, & 12 months. Rates of suicide ideation declined faster in intervention patients compared with usual care patients. Intervention patients had a more favourable course of depression in both degree & speed of symptom reduction; group difference peaked at 4 months. The effects on depression were not significant among patients with minor depression unless suicide ideation was present. (78 refs,)