Late-life depression and the death of Queen Victoria.

OBJECTIVE

The objective of this study was to evaluate relationships between the death of Queen Victoria and the depressive episode she experienced during the last year of her life.

METHODS

The last volume of Queen Victoria's personal Journal was reviewed from a geriatrician's perspective, tracing the onset and course of depressive symptoms from entries beginning on 17 August 1900 and ending on 13 January 1901, 9 days before her death. The Queen's own words are supplemented with observations from contemporaneous secondary sources.

RESULTS

The antecedents of Queen Victoria's late-life depression, including multiple losses, disabilities, and chronic pain, taken together with the presentation of vegetative, affective, and late cognitive symptoms, suggested the presence of a distinctively geriatric major depressive disorder. The absence of any other medical condition to explain the clinical picture seemed probable but not certain.

CONCLUSIONS

Although historians and biographers have long been aware of Queen Victoria's final depression, the emphasis has mostly been on her earlier and prolonged mourning for her husband Prince Albert. Re-examined now, the Queen's Journal suggests that a severe late-life depressive episode occurring approximately in her last 5 months contributed meaningfully to her death.