Klausner E J, Alexopoulos G S
Department of Psychiatry at the Joan and Sanford I. Weill Medical College of Cornell University and the New York Hospital-Cornell Medical Center, Westchester Division, USA.
Psychiatr Serv. 1999 Sep;50(9):1198-204. doi: 10.1176/ps.50.9.1198.
Geriatric psychiatric disorders usually occur in the context of medical illness, disability, and psychosocial impoverishment. Preliminary evidence suggests that psychotherapy can reduce not only psychopathology but also physical complaints, pain, and disability and that it can improve compliance with medical regimens. Psychotherapy has been found effective in treatment of depression related to bereavement and caregiver burden. Modification of available treatment strategies to address infirmity and life adversity may have a major impact on rehabilitation from psychiatric and medical disorders and may reduce utilization of nonpsychiatric health services. Most elderly patients with psychiatric problems prefer to be treated by their primary care physician. Models need to be developed and tested to integrate psychotherapy and other mental health services in primary care settings so that timely and appropriately targeted interventions can be provided.
老年精神障碍通常发生在身患疾病、残疾以及心理社会贫困的背景下。初步证据表明，心理治疗不仅可以减轻精神病理学症状，还能减少身体不适、疼痛和残疾，并且可以提高对医疗方案的依从性。心理治疗已被证明对治疗与丧亲之痛和照顾者负担相关的抑郁症有效。调整现有的治疗策略以应对体弱和生活困境，可能会对精神和医学疾病的康复产生重大影响，并可能减少非精神科医疗服务的使用。大多数有精神问题的老年患者更愿意由他们的初级保健医生进行治疗。需要开发和测试相关模式，以便在初级保健环境中整合心理治疗和其他心理健康服务，从而能够提供及时且目标明确的干预措施。
