Department of Psychology, University of Maine, Orono, ME.
Department of Psychology, University of Maine, Orono, ME.
Am J Geriatr Psychiatry. 2018 Jan;26(1):107-122. doi: 10.1016/j.jagp.2017.06.011. Epub 2017 Jun 16.
Is depression among older adults symptomatically different than younger adults? Is it more common or chronic or difficult to treat? Is depression in late life more likely to be attributed to psychological problems? Twenty-years ago, Dan Blazer, a pioneer known for his groundbreaking work on depression in older adulthood, conducted an important review of the existing literature to refute five commonly held beliefs about depression in late life. Now, two decades later, we call upon selected articles that are representative of our current knowledge to provide an update and identify research priorities. The research consensus spanning the past 20 years suggests that when compared with their younger counterparts, depression in older adults is not more common and is not more often caused by psychological factors. Although some studies have suggested that depression in late life may be symptomatically different and characterized by a more somatic presentation, there is insufficient empirical evidence to conclude that depression presents differently across adulthood. Overall, older adults respond to psychological interventions as well as younger adults, although evidence suggests that antidepressants are less efficacious in late life. Finally, compared with middle-aged adults, depression in older adults is associated with a more chronic course (i.e., higher rate of relapse), which is likely moderated by medical comorbidity. This special article summarizes our current understanding of the nature and treatment of late-life depression and highlights areas of inquiry in need of further study.
老年人的抑郁症在症状上是否与年轻人不同？它更常见、更慢性或更难治疗吗？老年人的抑郁症更有可能归因于心理问题吗？二十年前，以开创性研究老年人抑郁症而闻名的先驱者丹·布莱泽（Dan Blazer）对现有文献进行了重要综述，以驳斥关于老年人抑郁症的五个常见观点。现在，二十年后，我们选择了一些具有代表性的文章，对现有知识进行更新，并确定研究重点。过去 20 年的研究共识表明，与年轻人相比，老年人的抑郁症并不更常见，也不更多地由心理因素引起。尽管一些研究表明，老年人的抑郁症在症状上可能有所不同，表现为更多的躯体症状，但没有足够的证据表明抑郁症在成年期表现不同。总的来说，老年人对心理干预的反应与年轻人一样好，尽管有证据表明抗抑郁药在老年人群体中的效果较差。最后，与中年成年人相比，老年人的抑郁症与更慢性（即更高的复发率）有关，这可能由医学合并症所调节。这篇专题文章总结了我们对老年抑郁症的性质和治疗的现有认识，并强调了需要进一步研究的探究领域。
