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Speed of Improvement in Sleep Disturbance and Anxiety Compared With Core Mood Symptoms During Acute Treatment of Depression in Old Age

From Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA (AYD, BHM, SM, PRH, KS, CFR), Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto (BHM), and Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA (REB-B).

Objectives: The objective of this study was to examine the relative speed of improvement in sleep disturbance and anxiety symptoms compared with core mood symptoms in acute treatment of late-life major depression.

Method: The authors conducted secondary analysis of acute treatment data in 470 older patients treated in three federally funded studies. The authors compared rates of improvement in three Hamilton Rating Scale for Depression symptom clusters after stratification by study.

Results: Anxiety symptoms improved more slowly with antidepressant monotherapy and with combined pharmacotherapy/psychotherapy, whereas sleep symptoms improved at a similar rate as core mood symptoms.

Conclusions: Anxiety symptoms tend to persist in patients with late-life depression.

Key Words: Depression • geriatric • treatment • symptoms • sleep • anxiety • mood