[Depression in late life].

Nihon Ronen Igakkai Zasshi

Department of Psychiatry, St. Marianna University School of Medicine.

Published: July 1991

Depression is the most common psychiatric condition encountered in elderly people. The present paper intended to first review past epidemiological studies on depression in late life and secondly to investigate the symptomatological characteristics of depression in the elderly. The author also report significant results of a therapeutic approach to late-life depression, including antidepressant drug treatment and non-convulsive electric shock therapy. Previous epidemiological studies on prevalence rate of late life depression can be divided into two distinct groups according to their different methodologies including subjective and objective evaluations. Approximately 30% subjectively evaluated and 3% objectively evaluated in elderly people older than 65 years of age were depressed with depressed women outnumbering men approximately 2 to 1. Comparisons of the symptomatological characteristics were made in an extremely wide series of 104 depressed in-patients. Depressed patients with hypochodriacal complaints, pseudo-dementia, delusion and suicidal urges increased with aging. Depressed patients with a genetic factor decreased with aging, suggesting that the depressed patients in late life seems to have multiple etiological factors. We intended to correlate the plasma levels of various antidepressant drugs to the age of the depressed patients. There were significant positive correlations between the plasma levels and the age in patients with tricyclic antidepressant (amoxapine, dothiepin) treatment while on the other hand, no significant correlation was found between the two values in the patients with non-tricyclic antidepressant (setiptiline) treatment. These results suggest that non-tricyclic antidepressant drug should be selected for the treatment of depression in the elderly.(ABSTRACT TRUNCATED AT 250 WORDS)

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