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Tijdschrift voor Psychiatrie 25 (1983) 5, 303 - 332

Short report

Depression and the elderly person

J. Godderis

In this review the assumption of a specific relationship between old age and depression will be examined. Depression in the elderly appears to be more frequent than clinicians commonly believe. The prevalence of depressive symptoms at old age is probably higher than the calculated risk for depression in the general population, although an exact estimate is difficult te obtain. The aetiology remains complex and more intricate than in younger subjects. Indeed, a rather large number of possible contributing factors appears te be intimately interlaced. Nevertheless, at present, no one has been able te identify a specific aetio-pathogenetic relationship between old age and depression. Therefore previous concepts of 'involutional' melancholia and/or 'senile' depression can no longer be retained as distinct nosological entities. Yet, the aging process may have a typical 'pathoplastic' influence on the clinical picture of depression. The presentation may in fact be subtle and even misleading, making depression in the elderly most difficult te recognize. The treatment in itself is not specific. Although opinions differ, , the elderly in general seem te respond te treatment almost as well as younger patients. Before selecting a psychotropic agent, some peculiar problems ought te be taken into consideration. Many factors indeed make the elderly more sensitive to those drugs than younger subjects.