Reynolds Iii C F
Professor of Psychiatry and Neuroscience, University of Pittsburgh School of Medicine; and Director, Mental Health Clinical Research Center for Late-Life Mood Disorders, USA.
Dialogues Clin Neurosci. 1999 Sep;1(2):95-9. doi: 10.31887/DCNS.1999.1.2/creynolds.
Depression in later life is usually a recurrent illness and often a chronic one, associated with increased health care utilization, amplification of the disability born of concurrent medical illness, decreased quality of life, increased risk for suicide, and cognitive impairment. The good news, however, is that maintenance treatments work and have a demonstrably positive impact on long-term illness course. Treatment response is especially variable, or brittle, in patients aged over 70; yet maintenance treatment with combined medication and psychotherapy is able to significantly reduce long-term treatment response variability, ensuring continued wellness. Further evaluation of cost-effectiveness is necessary in order to improve reimbursement for effective long-term treatment.
晚年抑郁症通常是一种复发性疾病，而且常常是慢性疾病，与医疗保健利用率增加、并发内科疾病导致的残疾加剧、生活质量下降、自杀风险增加以及认知障碍有关。然而，好消息是维持治疗有效，并且对长期病程有明显的积极影响。在70岁以上的患者中，治疗反应尤其多变，或者说不稳定；然而，联合药物治疗和心理治疗的维持治疗能够显著降低长期治疗反应的变异性，确保持续健康。为了提高对有效的长期治疗的报销额度，有必要进一步评估成本效益。
