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Titolo:
DIAGNOSIS AND TREATMENT OF GERIATRIC DEPRESSION
Autore:
LASSER R; SIEGEL E; DUKOFF R; SUNDERLAND T;
Indirizzi:
NIMH,GERIATR PSYCHIAT BRANCH,NIH,CTR CLIN,BLDG 10,RM 3D41,10 CTR DR,MSC 1264 BETHESDA MD 20892 CATHOLIC UNIV AMER,DEPT PSYCHOL WASHINGTON DC 20064
Titolo Testata:
CNS DRUGS
fascicolo: 1, volume: 9, anno: 1998,
pagine: 17 - 30
SICI:
1172-7047(1998)9:1<17:DATOGD>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
BEREAVEMENT-RELATED DEPRESSION; RECURRENT MAJOR DEPRESSION; LATE-LIFE DEPRESSION; CONSENSUS DEVELOPMENT CONFERENCE; SELECTIVE REUPTAKE INHIBITORS; PLACEBO-CONTROLLED TRIAL; AGE-OF-ONSET; ELDERLY PATIENTS; DOUBLE-BLIND; COMPLICATED GRIEF;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
136
Recensione:
Indirizzi per estratti:
Citazione:
R. Lasser et al., "DIAGNOSIS AND TREATMENT OF GERIATRIC DEPRESSION", CNS DRUGS, 9(1), 1998, pp. 17-30

Abstract

Geriatric depression is a common psychiatric illness affecting as many as one-third of the older population. With the growing number of elderly in many countries of the world, the morbidity and mortality associated with untreated and partially treated depression is of great concern from both a medical and economic perspective. Depression in the elderly often presents with more somatic or anxious features and less ofthe subjective sadness expressed by younger groups. In addition, in the elderly, depressive-spectrum disorders (which include minor depression, dysthymia, mixed anxiety/depression, bereavement-related depression and even suicidal ideation) are generally under-recognised and undertreated by health professionals. The clinical mismatch between high prevalence but undertreatment stems from patient and physician attitudes toward depression as a 'normal' response to aging and loss, diagnostically confusing medical illness-related symptomatology, and noncompliance with prescribed treatment. Furthermore, late-onset depression mayhold special prognostic value in the elderly, with the relationship between late-onset depression and cerebrovascular events and progressive dementing illness being particularly strong. Therapeutically, then has been a recent expansion in the pharmacological tools that can be used to treat depression. A variety of new agents are now available thathave adverse effect, pharmacodynamic and target-receptor profiles that differ from the older agents. For example, newer drugs that block the serotonin (5-hydroxytryptamine; 5-HT) transporter have supplanted older agents that cause more frequent and toxic adverse effects. These newer agents have also focused attention on the impact of polypharmacy on the hepatic cytochrome P450 system, which is responsible for drug metabolism and elimination. Electroconvulsive therapy and psychotherapyremain effective nonpharmacological treatments for geriatric depression. Generally, the opportunities for therapeutic intervention in geriatric depression suggest that greater diagnostic attention and more widespread application of treatments for this increasingly prevalent disorder continue to be needed.

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Documento generato il 04/04/20 alle ore 11:33:50