Reducing Suicidal Risk in Elderly Patients with Depression

Older Americans have a higher rate of completed suicide than the general public. Because most suicide victims visit primary-care physicians in the month before death, these authors studied an intervention involving individual management and guideline-concordant care for depressed elderly primary-care patients. Twenty primary-care practices were randomized to the intervention (320 patients) or to care as usual (278 patients). Patients visiting their physicians were identified as probably depressed by a two-stage screening test. The SSRI citalopram was the first-line therapy, with interpersonal therapy provided to the 25% of patients who refused medication.

Compared with patients in control practices, significantly more patients in interventio…