Koenig H G, Meador K G, Cohen H J, Blazer D G
Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC.
Arch Intern Med. 1988 Sep;148(9):1929-36.
Depressive symptoms and disorders were identified by structured psychiatric interview in 130 consecutively admitted male inpatients aged 70 years and over. Major depression was found in 11.5% and other depressive syndromes in 23%. While depressive symptoms and syndromes are common among the medically ill, this study demonstrated the need for careful diagnostic assessment of older patients with depressive symptoms before initiating treatment that may itself convey significant risk. Sociodemographic and health characteristics of older men at higher risk for depression were also identified. Patients more likely to be depressed were over age 75 years, had less formal education, experienced cognitive dysfunction, suffered from more severe medical illness (particularly recent myocardial infarction), and had a history of psychiatric illness. Depressive symptoms were also common among patients with renal or neurologic diseases, those having a family history of psychiatric illness, the unmarried, and the more severely disabled. Given the impact of depression on recovery from medical illness, compliance with medical therapy, and costs of extended hospital stays, detection and treatment of this disorder are imperative.
通过结构化精神科访谈，在130名连续收治的70岁及以上男性住院患者中识别出抑郁症状和障碍。发现重度抑郁症的比例为11.5%，其他抑郁综合征的比例为23%。虽然抑郁症状和综合征在患病者中很常见，但本研究表明，在启动本身可能带来重大风险的治疗之前，需要对有抑郁症状的老年患者进行仔细的诊断评估。还确定了抑郁症高危老年男性的社会人口统计学和健康特征。更易患抑郁症的患者年龄超过75岁，受教育程度较低，有认知功能障碍，患有更严重的疾病（尤其是近期心肌梗死），且有精神疾病史。抑郁症状在患有肾脏或神经系统疾病的患者、有精神疾病家族史的患者、未婚患者以及残疾更严重的患者中也很常见。鉴于抑郁症对疾病康复、药物治疗依从性以及延长住院时间成本的影响，对这种疾病的检测和治疗势在必行。
