Depression and Adverse Drug Reactions Among Hospitalized Older Adults | Depressive Disorders | JAMA Internal Medicine | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.204.186.91. Please contact the publisher to request reinstatement.
1.
Koenig  HGBlazer  DG Epidemiology of geriatric affective disorders.  Clin Geriatr Med. 1992;8235- 251Google Scholar
2.
Inouye  SKWagner  DRAcampora  D  et al.  A predictive index for functional decline in hospitalized elderly medical patients.  J Gen Intern Med. 1993;8645- 652Google ScholarCrossref
3.
Covinsky  KEFortinsky  RHPalmer  RMKresevic  DMLandefeld  CS Relation between symptoms of depression and health status outcomes in acutely ill hospitalized older persons.  Ann Intern Med. 1997;126417- 425Google ScholarCrossref
4.
Koenig  HGShelp  FGoli  VCohen  HJBlazer  DG Survival and health care utilization in elderly medical inpatients with major depression.  J Am Geriatr Soc. 1989;37599- 606Google Scholar
5.
Lacro  JPJeste  DV Physical comorbidity and polypharmacy in older psychiatric patients.  Biol Psychiatry. 1994;36146- 152Google ScholarCrossref
6.
Carney  RMFreedland  KEEisen  SARich  MWJaffe  AS Major depression and medication adherence in elderly patients with coronary artery disease.  Health Psychol. 1995;1488- 90Google ScholarCrossref
7.
Onder  GPedone  CLandi  F  et al.  Adverse drug reactions as cause of hospital admissions in the elderly.  J Am Geriatr Soc. In press.Google Scholar
8.
Lazarou  JPomeranz  BHCorey  PN Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies.  JAMA. 1998;2791200- 1205Google ScholarCrossref
9.
Ebbesen  JBuajordet  IErikssen  J  et al.  Drug-related deaths in a department of internal medicine.  Arch Intern Med. 2001;1612317- 2323Google ScholarCrossref
10.
Field  TSGurwitz  JHAvorn  J  et al.  Risk factors for adverse drug events among nursing home residents.  Arch Intern Med. 2001;1611629- 1634Google ScholarCrossref
11.
Carbonin  PPahor  MBernabei  RSgadari  A Is age an independent risk factor of adverse drug reactions in hospitalized medical patients?  J Am Geriatr Soc. 1991;391093- 1099Google Scholar
12.
Onder  GLandi  FDella Vedova  C  et al.  Moderate alcohol consumption and adverse drug reactions among older adults.  Pharmacoepidemiol Drug Saf. 2002;11385- 392Google ScholarCrossref
13.
Sheikh  JIYesavage  JA Geriatric Depression Scale (GDS): recent evidence and development of a shorter version.  Clin Gerontol. 1986;512- 13Google Scholar
14.
Shah  APhongsathorn  VBielawska  CKatona  C Screening for depression among geriatric inpatients with short version of the Geriatric Depression Scale.  Int J Geriatr Psychiatry. 1996;11915- 918Google ScholarCrossref
15.
Nardi  BDe Rosa  MPaciaroni  G  et al.  Clinical investigation on depression on a randomized and stratified sample in an elderly population [in Italian].  Minerva Psichiatr. 1991;32135- 144Google Scholar
16.
Hodkinson  HM Evaluation of a mental test score for assessment of mental impairment in the elderly.  Age Ageing. 1972;1233- 238Google ScholarCrossref
17.
Rocca  WABonaiuto  SLippi  A  et al.  Validation of the Hodkinson abbreviated mental test as a screening instrument for dementia in an Italian population.  Neuroepidemiology. 1992;11288- 295Google ScholarCrossref
18.
Pahor  MChrischilles  EAGuralnik  JMBrown  SLWallace  RBCarbonin  PU Drug data coding and analysis in epidemiological studies.  Eur J Epidemiol. 1994;10405- 411Google ScholarCrossref
19.
Not Available, International Classification of Diseases, Ninth Revision, Clinical Modification.  Washington, DC2nd ed. Public Health Service–Health Care Financing Administration1980;
20.
Charlson  MEPompei  PAles  KLMackenzie  CR A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.  J Chronic Dis. 1987;40373- 383Google ScholarCrossref
21.
World Health Organization, International drug monitoring: the role of the hospital.  World Health Organ Tech Rep Ser. 1969;4255- 24Google Scholar
22.
Naranjo  CABusto  USellers  EM  et al.  A method for estimating the probability of adverse drug reactions.  Clin Pharmacol Ther. 1981;30239- 245Google ScholarCrossref
23.
Rodin  GVoshart  K Depressive symptoms and functional impairment in the medically ill.  Gen Hosp Psychiatry. 1987;9251- 258Google ScholarCrossref
24.
Barsky  AJGoodson  JDLane  RSCleary  PD The amplification of somatic symptoms.  Psychosom Med. 1988;50510- 519Google ScholarCrossref
25.
Katon  W The impact of major depression on chronic medical illness.  Gen Hosp Psychiatry. 1996;18215- 219Google ScholarCrossref
26.
Engel  GL A life setting conducive to illness: the giving-up--give-up complex.  Ann Intern Med. 1968;69293- 300Google ScholarCrossref
27.
Cacioppo  JTBurleson  MHPoehlmann  KM  et al.  Autonomic and neuroendocrine responses to mild pychological stressors: effects of chronic stress on older women.  Ann Behav Med. 2000;22140- 148Google ScholarCrossref
28.
Lehofer  MMoser  MHoehn-Saric  R  et al.  Major depression and cardiac autonomic control.  Biol Psychiatry. 1997;42914- 919Google ScholarCrossref
29.
Ader  RCohen  NFelten  D Psychoneuroimmunology: interactions between the nervous system and the immune system.  Lancet. 1995;34599- 103Google ScholarCrossref
Original Investigation
February 10, 2003

Depression and Adverse Drug Reactions Among Hospitalized Older Adults

Graziano Onder, MD; Brenda W. J. H. Penninx, PhD; Francesco Landi, MD, PhD; et al Hal Atkinson, MD; Matteo Cesari, MD; Roberto Bernabei, MD; Marco Pahor, MD; for the Investigators of the Gruppo Italiano di Farmacoepidemiologia nell'Anziano Study
Author Affiliations

From the Section of Gerontology and Geriatrics, Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC (Drs Onder, Penninx, Atkinson, and Pahor); and Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy (Drs Onder, Landi, Cesari, and Bernabei). A complete list of the Gruppo Italiano di Farmacoepidemiologia nell'Anziano investigators has been published previously (Eur J Epidemiol. 1999;15:893-901).

Arch Intern Med. 2003;163(3):301-305. doi:10.1001/archinte.163.3.301
Abstract

Background  Depression is a common disorder among hospitalized older adults, and it has been associated with adverse outcomes during hospital stays, including increased risk of morbidity and mortality and reduced recovery rates from illness and disability. The aim of this study was to assess whether depression may be a risk factor for adverse drug reactions (ADRs) among hospitalized older adults.

Methods  A total of 3134 older patients admitted to 23 hospitals throughout Italy between May 1 and June 30 and September 1 and October 31, 1998, entered the study. Patients with a short-form Geriatric Depression Scale score of 5 or greater were considered depressed. Adverse drug reactions observed during hospital stays and classified as definite or probable on the basis of the Naranjo algorithm were considered for this study.

Results  During the hospital stays, 192 ADRs were identified in 183 patients (5.8% of the sample). Cardiovascular and arrhythmic complications (20.3% of all ADRs) were the most frequent ADRs, followed by gastrointestinal (18.8%), dermatologic and allergic (12.5%), hemorrhagic (11.5%), and electrolyte (9.9%) disturbances. Adverse drug reactions were recorded in 101 (7.4%) of 1363 depressed patients and in 82 (4.6%) of 1771 nondepressed patients (P = .001). After adjusting for potential confounders, depression was associated with a significantly higher rate of ADRs (odds ratio, 1.58; 95% confidence interval, 1.14-2.20; P = .006). This effect seemed more pronounced in women (odds ratio, 1.85; 95% confidence interval, 1.16-2.95) than in men (odds ratio, 1.38; 95% confidence interval, 0.85-2.34).

Conclusion  In older hospitalized patients, depression seems to be associated with a greater occurrence of ADRs.

×