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Duke Study Suggests New Approach Treats Arthritis, Mind

Posted December 26, 2003

— Arthritis affects about half of those over age 65 and it often leads to depression. A new study at Duke University suggests that a new approach could help patients by treating not just their joints, but their minds.

Retired Duke psychology professor Marty Lakin is an expert on the mind, but he was unprepared for the effect Parkinson's Disease and middle ear problems would have on him.

"[I was] a lot older. A lot weaker and a lot more vulnerable," he said.

Lakin joined a study program through Duke Hospital called Impact to see how better primary care for depression might impact problems linked to chronic illnesses. Researchers said doctors often focus on treating physical problems alone and not the mental ones.

"They haven't had time to delve into the deeper issues of depression," Duke internist Dr. Linda Harpole said.

Health officials said depression can make the physical ailments worse. Patients often accept depressed feelings as normal, so they do not complain. Harpole said doctors need to ask questions that may reveal depression.

"It really isn't normal to feel this bad. There's something we can do to make the patients feel better," Harpole said.

"Life is a prolonged series of depression in a way," Lakin said.

The study results show treating depression in a primary care setting improved patients' perceptions about pain. They were more able to follow through with recommended medications, exercise and nutrition. For arthritis patients, the changed attitudes came with a physical benefit as well.

"While treating the depression, the arthritis also improved and their functioning improved," Harpole said.

Lakin is an example of how the same care may impact other chronic illnesses.

"It dealt with me in terms of the problems I was having, which were primarily physical, but also mood-wise," he said.

The Impact study results suggest primary care practices need to be re-organized to better treat depression. The study model included a depression care manager in each doctor's office.

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