Liptzin B
Geriatric Psychiatry, McLean Hospital, Belmont, MA.
Public Health Rep. 1987 Jul-Aug;102(4 Suppl):34-8.
The number of elderly women is growing in absolute numbers and in proportion to the U. S. population. Current epidemiologic research indicates that the most frequent psychiatric disorders among older women are phobias, severe cognitive impairment, dysthymia, and major depressive episode without grief. The rates of all of these disorders, except for cognitive impairment, are lower for older than for younger women. The rates of psychiatric disorders in older women are higher than in older men, except for alcohol abuse-dependence, which is higher in men. Depression is a common psychiatric problem in older women. The differential diagnosis includes other medical disorders, drug effects, normal grief, and early dementia. Older depressed women may present with physical complaints rather than complaints of depression, and thus be misdiagnosed. Treatment consists of psychotherapy, antidepressant medication, and activities to improve self-esteem. Dementia affects 4 percent of elderly women over age 65, and 20 percent of those over age 85. The most common cause is Alzheimer's disease. Current research is focusing on abnormalities in the cholinergic system in the brain. A careful psychiatric evaluation may identify medical conditions, including depression, which can be treated and can lead to improvements in the patient's functioning.
老年女性的数量在绝对数量上以及相对于美国人口的比例上都在增长。当前的流行病学研究表明，老年女性中最常见的精神障碍是恐惧症、严重认知障碍、心境恶劣以及无悲痛的重度抑郁发作。除认知障碍外，所有这些障碍的发病率在老年女性中均低于年轻女性。老年女性的精神障碍发病率高于老年男性，但酒精滥用 - 依赖除外，男性的酒精滥用 - 依赖发病率更高。抑郁症是老年女性常见的精神问题。鉴别诊断包括其他躯体疾病、药物作用、正常悲痛反应以及早期痴呆。老年抑郁女性可能表现为躯体不适而非抑郁症状，因此可能被误诊。治疗包括心理治疗、抗抑郁药物治疗以及提高自尊的活动。痴呆影响65岁以上老年女性的4%，85岁以上老年女性的20%。最常见的病因是阿尔茨海默病。当前的研究集中在大脑胆碱能系统的异常。仔细的精神科评估可能识别出包括抑郁症在内的躯体疾病，这些疾病可以得到治疗并能改善患者的功能。
