Gallarda Thierry
Unité d'évaluation diagnostique et thérapeutique des troubles psycho-comportementaux de la personne âgée, CH Sainte-Anne, Paris, France.
Psychol Neuropsychiatr Vieil. 2004 Sep;2 Suppl 1:S43-51.
Depressive symptoms are observed in many organic brain diseases in the elderly, particularly in stroke, degenerative or vascular dementias and Parkinson's disease. In many cases, an accurate estimation of the respective part of neurobiological abnormalities, adjustment disorders, disability and narcissistic wounds related to the disease appears very difficult for the practitioner. Specific data on the therapeutical aspects of secondary depressive disorders remains quite scarce. The efficacy of antidepressant drugs may be less important in geriatric depression with cerebral disorders or "secondary depressions" than in primary ones. Consequently, electroconvulsive-therapy may appear as an interesting therapeutical option for these patients.
在许多老年器质性脑疾病中可观察到抑郁症状,尤其是在中风、退行性或血管性痴呆以及帕金森病中。在许多情况下,临床医生很难准确评估与疾病相关的神经生物学异常、适应障碍、残疾和自恋创伤各自所占的比重。关于继发性抑郁障碍治疗方面的具体数据仍然相当匮乏。与原发性抑郁相比,抗抑郁药物在患有脑部疾病或“继发性抑郁”的老年抑郁症中的疗效可能没那么重要。因此,电休克治疗可能是这些患者一个有意思的治疗选择。