Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-23T14:15:50.475Z Has data issue: false hasContentIssue false
  • English
  • Français

Managing depression in older people

Published online by Cambridge University Press:  02 January 2018

Cornelius Katona
Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Although common and disabling, depression in old age remains both underdetected and under-treated. This is particularly regrettable in view of its high risk of chronicity, recurrence and suicide, as well as the considerable burden of associated health care costs. Despite the availability of a variety of physical and psychological treatment options of well-established efficacy, there is little recent evidence of improvement in either clinical practice or patient outcome. An understanding of the principles of management of depression in elderly patients requires some knowledge of the differences between such patients and their younger counterparts. The clinical presentation and diagnosis of depression in old age, its epidemiology and prognosis are reviewed briefly below, before focusing on the practicalities of treatment.

Type
Research Article
Information
Advances in Psychiatric Treatment , Volume 2 , Issue 4 , July 1996 , pp. 178 - 185
Copyright
Copyright © The Royal College of Psychiatrists 1996 

References

Alexopoulos, G. S. (1989). Biological abnormalities in late life depression. Journal of Geriatric Psychiatry, 22, 25–34.Google ScholarPubMed
Alexopoulos, G. S., Abrams, R. C., Young, R. C. et al (1988) Cornell Scale for depression in dementia. Biological Psychiatry, 23, 271–284.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
Anstey, K. & Brodaty, H. (1995) Antidepressants and the elderly: double-blind trials 1987–1992. International Journal of Geriatric Psychiatry, 10, 265–279.CrossRefGoogle Scholar
Cole, M. G. (1990) The prognosis of depression in the elderly. Canadian Medical Association Journal, 142, 633–639.Google Scholar
Copeland, J. R. M., Dewey, M. E. & Griffith-Jones, H. M. (1986) A computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 89–99.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Davidson, I. A., Dewey, M. E. et al (1992) Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool. British Journal of Psychiatry, 161, 230–239.CrossRefGoogle ScholarPubMed
Gerson, S. C., Plotkin, D. A. & Jarvik, L. F. (1988) Antidepressant drug studies 1946 to 1986: empirical evidence for aging patients. Journal of Clinical Psychopharmacology, 8, 311–322.Google Scholar
Godber, C., Rosenvinge, H., Wilkinson, D. et al (1987) Depression in old age: prognosis after ECT. International Journal of Geriatric Psychiatry, 2, 19–24.CrossRefGoogle Scholar
Iliffe, S., Mitchley, S., Gould, M. et al (1994) Evaluation of the use of brief screening instruments for dementia, depression and problem drinking among elderly people in general practice. British Journal of General Practice, 388, 503–508.Google Scholar
Katona, C. L. E. (1994a) The epidemiology of depression in old age. In Depression in Old Age (ed. Katona, C. L. E.) pp. 30–41. Chichester: John Wiley.Google ScholarPubMed
Katona, C. L. E. (1994b) The prognosis of depression in old age. In Depression in Old Age (ed. Katona, C. L. E.) pp. 123–140. Chichester: Wiley.Google ScholarPubMed
Katona, C. L. E., Freeling, P., Hinchliffe, K. et al (1995) Recognition and management of depression in late life in general practice: consensus statement. Primary Care Psychiatry, 1, 107–113.Google Scholar
Macdonald, A. J. D. (1986) Do general practitioners “miss” depression in elderly patients? British Medical Journal, 292, 1365–1367.CrossRefGoogle ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Morris, R. G. & Morris, L. W. (1991) Cognitive and behavioural approaches with the depressed elderly. International Journal of Geriatric Psychiatry, 6, 407–413.CrossRefGoogle Scholar
Mullan, E., Katona, P., D'Ath, P. et al (1994) Screening, detection and management of depression in elderly primary care attenders. 2. Detection and fitness for treatment: a case record study. Family Practice, 11, 267–270.CrossRefGoogle Scholar
Mulsant, B. H., Rosen, J., Thornton, J. E. et al (1991) A prospective naturalistic study of electroconvulsive therapy in late-life depression. Journal of Geriatric Psychiatry and Neurology, 4, 3–13.CrossRefGoogle ScholarPubMed
Murphy, E., Smith, R., Lindesay, J. et al (1988) Increased mortality rates in late-life depression. British Journal of Psychiatry, 152, 347–353.CrossRefGoogle ScholarPubMed
Old Age Depression Interest Group (1993) How long should the elderly take antidepressants? A double-blind placebo-controlled study of continuation/prophylaxis therapy with dothiepin. British Journal of Psychiatry, 162, 175–182.CrossRefGoogle Scholar
Ong, Y. K., Martineau, F., Lloyd, C. et al (1987) A support group for the depressed elderly. International Journal of Geriatric Psychiatry, 2, 119–123.CrossRefGoogle Scholar
Rapp, S. R., Walsh, D. A., Parisi, S. A. et al (1988) Detecting depression in elderly medical in-patients. Journal of Consulting and Clinical Psychology, 56, 509–513.CrossRefGoogle Scholar
Wragg, R. E. & Jeste, D. V. (1989) Overview of depression and psychosis in Alzheimer's disease. American journal of Psychiatry, 146, 577–586.Google ScholarPubMed
Yesavage, J. A., Brink, T. L., Rose, T. L. et al (1983) Development and validation of a Geriatric Depression Screening Scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar
Zung, W. W. K. (1965) A self-rating depression scale. Archives of General Psychiatry, 12, 63–70.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.