Mulsant Benoit H, Whyte Ellen, Lenze Eric J, Lotrich Francis, Karp Jordan F, Pollock Bruce G, Reynolds Charles F
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
CNS Spectr. 2003 Dec;8(12 Suppl 3):27-34. doi: 10.1017/s1092852900008257.
Depression and anxiety disorders are very common in the elderly. Data accumulated over the past 2 decades have shown that most older patients can tolerate and respond to acute treatment with serotonergic antidepressants, other psychotropic agents, or manual-based psychotherapy. However, outcomes under usual-care conditions remain poor. This review proposes that clinicians may significantly improve the long-term outcomes of their older patients with depression and anxiety by focusing on four key factors: (1) identification and treatment of comorbid conditions; (2) full remission of acute symptoms; (3) education of patients, families, and professional colleagues about the need for long-term treatment; and (4) prevention and management of medication side-effects.
抑郁症和焦虑症在老年人中非常常见。过去20年积累的数据表明，大多数老年患者能够耐受血清素能抗抑郁药、其他精神药物或基于手册的心理治疗的急性治疗并产生反应。然而，在常规护理条件下的治疗效果仍然很差。本综述提出，临床医生可以通过关注四个关键因素，显著改善老年抑郁症和焦虑症患者的长期治疗效果：（1）识别和治疗共病；（2）急性症状完全缓解；（3）对患者、家属和专业同事进行长期治疗必要性的教育；（4）预防和管理药物副作用。
