Abstract
In aged individuals, the morbidity of major depression may confer a worse vital prognosis, and failure to seek medical treatment may result in the disorder becoming chronic. To elucidate the influence of medical treatment-receiving behavior on the one-year outcome, we studied untreated aged individuals with depression who had been identified by a community screening program. The participants in this study were 898 community-dwelling residents of both sexes (in Itabashi Ward, Tokyo) aged 65 to 84 years (first survey conducted in October 2011). Eligibility for entry into the study was determined by reference to a depression-related basic checklist, established by the Ministry of Health, Labour and Welfare. Of the individuals with a positive checklist result, 76 from whom informed consent had been obtained underwent diagnosis by a physician using the Structured Clinical Interview for DSM-IV. Thirteen individuals with major depressive disorder were then identified. A follow-up survey conducted one year later showed that major depressive disorder was still present in seven individuals and partial remission had occurred in two. In 2011, a referral letter to attend a medical institution was sent to all of the subjects diagnosed with major depression. In spite of this, only one individual attended a medical institution during the year, and the one-year outcome in untreated individuals was poor. Even in the one individual in whom therapy was instituted, the result was not adequate because of poor compliance. We thus consider it important not only to support aged individuals who should attend a medical institution, but also to provide continual support to enhance the effect of treatment after attending the institution.
