HealthDay News — For older adults with subthreshold depression, collaborative care is associated with a reduction in depressive symptoms compared with usual care, according to a study published in the Journal of the American Medical Association.

Simon Gilbody, PhD, from the University of York in the United Kingdom, and colleagues randomized participants aged 65 years or older with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) subthreshold depression to collaborative care (344 participants), which was coordinated by a case manager who assessed functional impairments relating to mood symptoms, or to a control group (361 participants) which received usual primary care.

The researchers found that at 4-month follow-up, collaborative care resulted in lower 9-item Patient Health Questionnaire scores than usual care (mean, 5.36 vs 6.67; P <.001); at 12-month follow-up the corresponding scores were 5.93 and 7.25 (P =.001). At 4-month follow-up, 17.2 and 23.5% of participants met criteria for depression (relative risk, 0.83; 95% CI, 0.61 to 1.27; P =.25); at 12-month follow-up the corresponding proportions were 15.7 and 27.8% (relative risk, 0.65; 95% CI, 0.46 to 0.91; P =.01).

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“Among older adults with subthreshold depression, collaborative care compared with usual care resulted in a statistically significant difference in depressive symptoms at 4-month follow-up, of uncertain clinical importance,” the authors wrote.


Gilbody S, Lewis H, Adamson J, et al. Effect of collaborative care vs usual care on depressive symptoms in older adults with subthreshold depression: The CASPER randomized clinical trialJAMA. 2017;317(7):728-737. doi:10.1001/jama.2017.0130