Depressive storungen und erkrankungen im hoheren lebensalter

Translated title of the contribution: Depressive symptoms and depressive

H. Forstl, G. Stoppe

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Depressive symptoms can be observed in 10% to 30%, full-blown depressive episodes in up to 10% of the elderly population. Psychosocial stressors (bereavement) and somatic factors are more common; whereas genetic causes are found less frequently in elderly depressives. The prognosis is less favourable due to a higher proportion of patients with a chronic course of illness and a higher mortality. Clinical diagnosis can not rely on depressed mood - often marked by other features, e.g. anhedonia, loss of drive, anxiety and a variety of somatic complaints - as a core symptom. Differential diagnostic exercises should not be aimed at discarding concomitant, but apparently less important contributing factors of a depressive syndrome, but rather at collecting all evidence of features and causes accessible to symptomatic and causal treatment. Beyond the distinction between depressive disturbances (F 3 X.Y), adjustment disorders (F 43. X) and organic depressive disturbances (F 06.3) according to ICD-10, the following diagnostic facets should be considered: anxiety disorders, dependence, incipient dementia. If available, the patient's family has to be included in the treatment programme. Information for patient and family about the nature, treatment and likely course of the illness forms an obligatory part of the treatment programme. Cognitive Psychotherapeutic approaches may suffice for mild depressive episodes, and they should be combined with psychopharmacological treatment for moderate and severe episodes. Vigorous attempts at the medical treatment of relevant comorbidity and psycho-social support have to be made available p.r.n.

Translated title of the contributionDepressive symptoms and depressive
Original languageGerman
Pages (from-to)165-172+289
JournalFortschritt und Fortbildung in der Medizin
Volume23
StatePublished - 1999
Externally publishedYes

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