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Treatment of Depression in the Elderly

  • R. M. Fraser
Part of the Ettore Majorana International Science Series book series (PSLI)

Abstract

It is still inadequately recognised that the term ‘depression’, like so many others in psychiatry, takes in its medical context a meaning somewhat different from that of its normal lay usage, and from this failure of recognition arise many of the difficulties that are experienced in the diagnosis and treatment of the syndrome. Clinical depression is more than a mere alteration mood; it is,a true ‘depression’ of a range of vital functions. There is depression of activity, of appetite, communicative ability, memory, gastro-intestinal function and sleep, there is alteration of endocrine function and there is distorted and pathological thinking. Illness is defined as loss of function, and thus clinical depression can be regarded as a true illness, many of its functional impairments being life-threatening, especially in elderly people. The incidence of suicide in the elderly is high1,2 but death and chronic morbidity are just as likely, indeed more likely, to arise from self-neglect and its consequences, Malnutrition, accidents, pressure sores, and deep venous thrombosis are Just some of the dismal results of depressive illness, and perhaps of even greater concern is the insidious loss of independence that overtakes old people in hospital when their condition has not been speedily recognized and treated.

Keywords

Depressed Patient Electroconvulsive Therapy Depressive Illness Chronic Morbidity Elderly Depressed Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    P. Sainsbury, Suicide in later life,Geront.Clin. 4: 161 (1962)CrossRefGoogle Scholar
  2. 2.
    K. Schulman, Suicide and parasuicide in old age: a review,Age and Ageing7: 201 (1978)ADSCrossRefGoogle Scholar
  3. 3.
    M. D. Blumenthal, Heterogeneity and research on depressive disorders,Arch. Gen. Psych24: 524 (1971)CrossRefGoogle Scholar
  4. 4.
    R. M. Fraser, and I. B. Glass, Unilateral and bilateral ECT in elderly patients,Acta. Psychiat. Scand62: 13 (1980)CrossRefGoogle Scholar
  5. 5.
    A. Lewis, States of depression: their clinical and aetiological differentiation,Brit. med. J. ii: 875 (1938)CrossRefGoogle Scholar
  6. 6.
    J. J. Schildkraut, and P. J. Orsulak, Recent studies in the role of catecholamines in the pathophysiology and classification of depressive disorders,in“Neuroregulatory and Psychiatric Disorders” E. Usdin, D. A. Hamburg and J. D. Barchas, eds., Oxford University Press, Oxford (1977)Google Scholar
  7. 7.
    M. Asnis, E. J. Sachar, U. Halbreich, S. Nathan, L. Ostrow, and F. S. Halpern, Cortisol secretion and dexamethasone response in depression,Am. J. Psychiatry138: 9 (1981)Google Scholar
  8. 8.
    A. R. Green, and D. W: Costain, “Pharmacology and Biochemistry of Psychiatric Disorders” John Wiley & Sons, Chichester (1981)Google Scholar
  9. 9.
    L. F. Gram, and K. F. Overo, Drug interaction, inhibitory effect of neuroleptics on metabolism of tricyclic antidepressants in man.Brit. med. J1: 463 (1972)CrossRefGoogle Scholar
  10. 10.
    R. H. Girdwood, Deaths from tricyclic overdosage,Brit. med. J. I: 501 (1974)CrossRefGoogle Scholar
  11. 11.
    R. H. S. Mindham, Tricyclic antidepressants and amine precursors,in“Psychopharmacology of Affective Disorders” E. S. Paykel, and A. Coppen, eds., Oxford University Press, Oxford (1979)Google Scholar
  12. 12.
    P. K. Bridges, and T. R. E. Barnes, New antidepressant drugs,J. Pharmacother. Spring,. 12 (1978)Google Scholar
  13. 13.
    C. E. Page, Mianserin-induced agranulocytosis,Brit. med. J284: 1912 (1982)CrossRefGoogle Scholar
  14. 14.
    A. Carlsson, Some current problems relating to the mode of action of antidepressant drugs,in“Recent Advances in the Treatment of Depression” A. Carlsson, C-G. Gottf ries, G. Holmberg, K. Modigh, S,. Torgny, and S-0. Ogren, eds., Acta.Psychiat,. Scand. Suppl. 290, Munksgaard, Copenhagen (1981)Google Scholar
  15. 15.
    J. A. Abramczuk, and N. M. Rose, Pre-anaesthetic assessment and prevention of post-ECT mortality,Br. J. Psychiatry134: 582 (1979)CrossRefGoogle Scholar
  16. 16.
    R. M. Fraser, and I. B. Glass, Recovery from ECT in elderly patients,Br.J.Psychiatry133: 524 (1978)CrossRefGoogle Scholar
  17. 17.
    M. Hare, Clinical check-list for diagnosis of dementia,Brit. med. J. ii: 266 (1978)CrossRefGoogle Scholar
  18. 18.
    P. N. Nott, and J. J. Fleminger, Presenile dementia: the difficulties of early diagnosis,Acta Psychiat. Scand51: 210 (1975)CrossRefGoogle Scholar
  19. 19.
    M. A. Ron, B. K. Toone, M. E. Garralda, and W. A. Lishman, Diagnostic accuracy n presenile dementia,Br. J. Psychiatry134: 161 (1979)CrossRefGoogle Scholar
  20. 20.
    M. Roth, Treatment of depression in the elderly,in“Recent Advances in the Treatment of Depression” A. Carlsson, C-G. Gottfries, G. Holmb erg, K. Modigh, S. Torgny, and S-0. Ogren, eds.., Acta.Psychiat.Scand. Suppl. 290, Munksgaard, Copenhagen (1981)Google Scholar
  21. 21.
    J. Pippard, and L. Ellam, “Electroconvulsive Therapy in Great Britain, 1980: A Report to the Royal College of Psychiatrists” Gaskell, London (1981)Google Scholar

Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • R. M. Fraser
    • 1
  1. 1.Consultant Psychiatrist in Geriatric MedicineSt. Pancras HospitalLondonEngland

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