Chronic disease and depression in the geriatric population.

A brief review is given of the incidence and nature of psychiatric symptoms, particularly depression, that are associated with chronic physical diseases common in the elderly. A discussion of medical illnesses that mimic depression, and depression presenting as somatic disease, illustrates the challenge of differential diagnosis. Guidelines are presented for the treatment of depression in patients with central nervous system, cardiovascular, hepatic and renal, and gastrointestinal disorders. Pharmacokinetic factors relevant to the use of cyclic and monoamine oxidase inhibitor antidepressants in the elderly are reviewed.