Freedman N, Bucci W, Elkowitz E
J Am Geriatr Soc. 1982 Jun;30(6):372-7. doi: 10.1111/j.1532-5415.1982.tb02834.x.
This study addresses several major methodologic issues in the assessment of depressive illness among the elderly family practice living in the community. These include the selection of screening locale, the definition of depression in the elderly, and the evaluation of age trends within this group. The family physician's office is viewed as the optimal screening locale; this facility serves as the chief link between the elderly patient and the community health care system, for psychologic as well as physical complaints. In the definition of depression, a type of depressive illness particularly affecting the elderly may be distinguished from a syndrome more characteristic of depression in the population at large. Emphasis is laid on viewing aging as an evolving process rather than as a steady state. A pilot study of 166 chronically ill family practice patients living in the community was conducted. A large proportion of them, all without previously diagnosed psychiatric impairment, had elevated depression scores according to the Zung Depression Status Inventory. Distinct symptom clusters characteristic of depression in the aged were identified. The data also suggested a systematic age trend, with different peaks of depression for men and women within the elderly age range.
本研究探讨了社区老年家庭医疗中抑郁症评估的几个主要方法学问题。这些问题包括筛查地点的选择、老年人抑郁症的定义以及该群体内年龄趋势的评估。家庭医生办公室被视为最佳筛查地点；该机构是老年患者与社区医疗保健系统之间心理和身体疾病的主要联系纽带。在抑郁症的定义中，一种特别影响老年人的抑郁症类型可能与更具普遍人群抑郁症特征的综合征有所区别。重点在于将衰老视为一个不断发展的过程而非稳定状态。对166名居住在社区的慢性病家庭医疗患者进行了一项试点研究。他们中很大一部分人，之前均未被诊断出有精神障碍，根据zung抑郁状态量表，其抑郁得分升高。确定了老年人抑郁症特有的明显症状群。数据还表明存在系统性的年龄趋势，在老年年龄范围内男性和女性的抑郁症峰值不同。
