Gonda Xénia, Molnár Eszter, Torzsa Péter, Rihmer Zoltán
Semmelweis Egyetem, Altalános Orvostudományi Kar, Farmakológiai és Farmakoterápiás Intézet.
Psychiatr Hung. 2009;24(3):166-74.
With the increase of life expectancy the ratio of elderly people in our society also increases and consequently health problems related to old age gain more attention. The prevalence of depression does not decrease in the elderly, affective disorders in old people, however, often manifest masked by physical illness worsening the course of these somatic disorders. Elderly depression also tends to present with a peculiar clinical picture. Atypical and also only few symptoms are characteristic of depression in the elderly. Vegetative symptoms are often primary and depression in old people often manifests solely in somatic symptoms. Typical cognitive alterations and pseudodementia are also characteristic features. At the same time, typical affective symptoms of depression are often absent, and instead of psychomotor retardation, psychomotor agitation manifested as irritability or motor restlessness is frequent. In the diagnostic process depression in the elderly should be separated from somatic diseases and dementia. The correct diagnosis and treatment of depression in the elderly is very important, since old age depression does not only cause significant distress, but often leads to suicide, and in addition, it generally increases morbidity and mortality, worsens the general somatic condition of the patient and increases social isolation.
随着预期寿命的增加，我们社会中老年人的比例也在上升，因此与老年相关的健康问题受到更多关注。老年人中抑郁症的患病率并未降低，然而，老年人的情感障碍往往表现为被躯体疾病掩盖，从而使这些躯体疾病的病程恶化。老年抑郁症也往往呈现出一种特殊的临床表现。非典型症状以及仅有少数症状是老年抑郁症的特征。躯体症状往往是主要的，老年人的抑郁症常常仅表现为躯体症状。典型的认知改变和假性痴呆也是其特征。同时，抑郁症典型的情感症状往往不存在，而且常出现的不是精神运动迟缓，而是表现为易激惹或运动不安的精神运动性激越。在诊断过程中，应将老年抑郁症与躯体疾病和痴呆区分开来。正确诊断和治疗老年抑郁症非常重要，因为老年抑郁症不仅会造成极大痛苦，还常常导致自杀，此外，它通常会增加发病率和死亡率，使患者的总体躯体状况恶化，并加剧社会隔离。
