Bergener M
Schweiz Rundsch Med Prax. 1991 Feb 12;80(7):139-41.
Although depressions are the most frequent psychic disorders in the elderly diagnosis is often delayed and differential diagnosis complicated by other functional syndromes. Prevalent somatic symptoms such as somatic dysesthesias, pain, memory disorders and disorders of performance often mislead diagnostic search particularly if depressive alterations of mood are less prominent. Therefore history gains special importance beside physical examination. Three main groups are distinguished: --symptomatic (exogenous) depression --neurotic (reactive) depression --so called tardive depression Detection of nosologic connections is difficult but a prerequisite for a successful therapeutic approach. To this end particular attention should be given to connections between development of depression and history of life and coping with special events of life.
尽管抑郁症是老年人中最常见的精神障碍,但诊断往往延迟,且鉴别诊断因其他功能综合征而变得复杂。常见的躯体症状,如躯体感觉异常、疼痛、记忆障碍和行为障碍,常常误导诊断,特别是在情绪的抑郁变化不太突出时。因此,除体格检查外,病史具有特别重要的意义。可区分出三个主要类别:——症状性(外源性)抑郁症——神经性(反应性)抑郁症——所谓迟发性抑郁症。确定疾病分类学上的联系很困难,但却是成功治疗方法的前提。为此,应特别关注抑郁症的发展与生活史以及应对生活中特殊事件之间的联系。