Stoppe Gabriela
Universitäre Psychiatrische Kliniken, Wilheml Klein-Strasse 27, Basel, Switzerland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2008 Apr;51(4):406-10. doi: 10.1007/s00103-008-0508-7.
Depression is the most frequent psychiatric disorder in old age. Some patients have had depressive episodes or other psychological disorder in an earlier part of their life span. Older people show more somatic or cognitive complaints compared to younger depressives. Risk factors for depression in old age are (incident) physical disorders, sleep disorders or loss of spouse. Depression worsens course and prognosis of comorbid somatic disorders. A major consequence is the high suicide rate in the elderly. Depression is also a risk factor for other disorders like dementia or institutionalisation. The interplay between depression and dementia and other organic brain disorders is complex und still unresolved. Depression in the elderly is a challenge for our health system. Recognition and treatment rates are still too low. Integrative treatment plans for depression with comorbid physical disorders or in various settings should be developed. With the growing elderly population the available evidence for treatment urgently has to be increased. In current practice drug therapies--mostly inadequate--dominate. Psychotherapy should be promoted and the number of old age psychotherapists increased.
抑郁症是老年期最常见的精神障碍。一些患者在其生命早期曾有过抑郁发作或其他心理障碍。与年轻的抑郁症患者相比，老年人表现出更多的躯体或认知方面的主诉。老年期抑郁症的危险因素包括（新发）躯体疾病、睡眠障碍或配偶离世。抑郁症会使共病的躯体疾病的病程和预后恶化。一个主要后果是老年人自杀率很高。抑郁症也是痴呆或住院等其他疾病的危险因素。抑郁症与痴呆及其他器质性脑疾病之间的相互作用很复杂，仍未得到解决。老年期抑郁症对我们的卫生系统来说是一项挑战。识别率和治疗率仍然过低。应该制定针对伴有躯体疾病或在各种情况下的抑郁症的综合治疗方案。随着老年人口的不断增加，迫切需要增加现有的治疗证据。在当前的实践中，药物治疗——大多并不充分——占据主导地位。应该推广心理治疗并增加老年心理治疗师的数量。
