Lebowitz B D, Pearson J L, Schneider L S, Reynolds C F, Alexopoulos G S, Bruce M L, Conwell Y, Katz I R, Meyers B S, Morrison M F, Mossey J, Niederehe G, Parmelee P
National Institute of Mental Health, Bethesda, Md 20857, USA.
JAMA. 1997 Oct 8;278(14):1186-90.
To reexamine the conclusions of the 1991 National Institutes of Health Consensus Panel on Diagnosis and Treatment of Depression in Late Life in light of current scientific evidence.
Participants included National Institutes of Health staff and experts drawn from the Planning Committee and presenters of the 1991 Consensus Development Conference.
Participants summarized relevant data from the world scientific literature on the original questions posed for the conference.
Participants reviewed the original consensus statement and identified areas for update. The list of issues was circulated to all participants and amended to reflect group agreement. Selected participants prepared first drafts of the consensus update for each issue. All drafts were read by all participants and were amended and edited to reflect group consensus.
The review concluded that, although the initial consensus statement still holds, there is important new information in a number of areas. These areas include the onset and course of late-life depression; comorbidity and disability; sex and hormonal issues; newer medications, psychotherapies, and approaches to long-term treatment; impact of depression on health services and health care resource use; late-life depression as a risk factor for suicide; and the importance of the heterogeneous forms of depression. Depression in older people remains a significant public health problem. The burden of unrecognized or inadequately treated depression is substantial. Efficacious treatments are available. Aggressive approaches to recognition, diagnosis, and treatment are warranted to minimize suffering, improve overall functioning and quality of life, and limit inappropriate use of health care resources.
根据当前科学证据，重新审视1991年美国国立卫生研究院（National Institutes of Health）关于老年抑郁症诊断与治疗的共识小组的结论。
参与者包括美国国立卫生研究院工作人员以及来自规划委员会和1991年共识发展会议的演讲者的专家。
参与者总结了世界科学文献中与会议提出的原始问题相关的数据。
参与者回顾了原始共识声明并确定了需要更新的领域。问题清单分发给所有参与者，并进行修改以反映小组的共识。选定的参与者为每个问题准备了共识更新的初稿。所有参与者都阅读了所有初稿，并进行修改和编辑以反映小组共识。
审查得出结论，虽然最初的共识声明仍然成立，但在许多领域有重要的新信息。这些领域包括老年抑郁症的发病和病程；共病和残疾；性别和激素问题；更新的药物、心理治疗和长期治疗方法；抑郁症对卫生服务和医疗保健资源使用的影响；老年抑郁症作为自杀的危险因素；以及抑郁症不同形式的重要性。老年人的抑郁症仍然是一个重大的公共卫生问题。未被识别或治疗不足的抑郁症负担很大。有有效的治疗方法。有必要采取积极的方法进行识别、诊断和治疗，以尽量减少痛苦，改善整体功能和生活质量，并限制医疗保健资源的不当使用。
