As part of a comprehensive research agenda aimed at advancing the care of Veterans with depression, VA researchers are developing, testing, and implementing new models of primary care that do a better job of screening for and treating the disease. They are also studying ways to improve outcomes for Veterans affected by depression along with other conditions, such as heart disease or diabetes, and exploring the genetic and molecular roots of the condition, with the goal of developing more effective drugs.
Depression raises risk for heart disease—In a database study that tracked the health history of more than 350,000 Veterans over seven years, those with depression were at about 40 percent higher risk for heart attack, compared with those who did have depression. The study also found that general anxiety and panic disorder posed a similar increased risk of heart attack. PTSD also increased risk, but to a lesser extent. Several studies have found links between depression or anxiety and heart disease, but researchers are still working to determine the exact nature of the relationship, and the extent to which treating these mental health disorders can stem heart disease.
Telehealth treatment—A four-year study is examining whether talk therapy through in-home videoconferencing can help to treat older Veterans who have major depression. The study includes 224 Veterans living in or around Charleston, S.C. After eight weeks of treatment, patients will be followed for 12 months. This type of "telepsychology" could bring specialized mental health services to the homes of elderly and rural Veterans, as well as to many smaller VA community based outpatient clinics.
Electroconvulsive therapy underused—Electroconvulsive therapy (ECT), commonly known as "shock therapy," is an established treatment for severe or treatment-resistant depression, but a study shows it may be underused. A VA team in Ann Arbor found that only 307 of 187,811 VA patients who had received a diagnosis of depression between 1999 and 2004 underwent ECT. African Americans, those living in the South or West, those living farther from VA facilities offering the treatment, and those with major medical problems aside from depression were less likely to receive the therapy. The reasons for some of the disparities are unclear, but the researchers say VA and other health systems should "work to provide equitable access [to] and more consistent use of this safe and effective treatment."