The epidemiology and presentation of depression in the elderly
DOI:
https://doi.org/10.21504/sajg.v1i1.12Abstract
The epidemiology of depression in late life encompasses the distribution of the illness among the elderly and the factors influencing that distribution. This holistic approach has as its main task that of distinguishing the worried well from the serious psychiatric disorder. The assessment of the epidemiology of depression is fraught with problems and covers the aspects of case identification. their distribution, historical and aetiological studies, as well as the utilization of health services. To date. some key diagnostic categories have been identified, as well as some that still need to find a niche in the psychiatric nomenclature. In many elderly persons the presentation of depression varies considerably, covering a broad spectrum between a state of apparent wellbeing to that of marked psychological and/or physical symptoms. Researchers have thus put forward different diagnostic groupings and prevalence rates based on their assessment of mood states, functional disability. course of illness and prognosis. Discrepancies in the results of these studies among similar communities have further been compounded by the use of different instruments and approaches to depression. There is a strong need for consensus among researchers in this field.References
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American Psychiatric Association. 1987. Diagnostic and Statistical Manual of Mental Disorders. Edition III Reused. (DSM-III-R.) Washington.
Angst, J., Merikangas, K., Scheidegger, P. & Wicki, W. 1990. Recurrent brief depression: a new subtype of affective disorders. Journal of Affective Disorders, 19: 87-98.
Barnes, J.M. & Yach, D. 1991. A survey of health aspects of black elderly living in a settled and newly developed township in the Cape Metropolitan area. Cape Town: Medical Research Council. Urbanisation and Health National Programme, Technical Report. No 2.
Ben-Arie, O., Swartz, L,, Teggin. A.F. & Elk, R. 1983. The Coloured elderly in Cape Town - a psychosocial, psychiatric and medical community survey. Part 2. Prevalence of psychiatric disorders. South African Medical Journal, 64: 1056-61.
Blazer, D.G. 1989a. The epidemiology of psychiatric disorders in late life. In: Busse, D.G. & Blazer, D.G, (Eds) Geriatric psychiatry. Washington: American Psychiatric Press, pp. 235-60.
Blazer, D.G. 1989b. Affective disorders in late life. In: Busse. E. W. & Blazer. D.G. (Eds) Geriatric psychiatry. Washington: American Psychiatric Press, pp. 369-401.
Blazer, D.G. 1991. Clinical features in depression in old age: a case for minor depression. Current Opinion in Psychiatry. 4: 596-99.
Blazer. D., Woodbury, M. & Hughes. D.C. et al. 1989. A statistical analysis of the classification of depression in a mixed community and clinical sample. Journal of Affective Disorders. 16: 11-20.
Copeland, J.R.M., Gurland. B.J. & Dewey, M.E. 1987. Is there more dementia. depression and neurosis in New York? A comparative community study of the elderly in New York and London using the community diagnosis AGECAT. British Journal of Psychiatry. 151: 466-73,
Gillis, L.S., Elk, R., Trichard, L., Le Fevre, K., Zabow. A., Joffe, H. & van Schalkwyk, D.J. 1982. The admission of the elderly to places of care: a socio-psychiatric community survey. Psychological Medicine, 12: 15968.
Gillis, L.S., Welman, M., Koch, A. & Joyi, M. 1991. Psychological distress and depression in urbanising elderly black persons. South African Medical Journal, 79(8): 490-95.
Gillis, L.S. & Zabow, A. 1982. Dysphoria in the elderly. South African Medical Journal, 62: 410-13.
Hamilton, M. 1960. Rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23:56-62.
Hamilton, M. 1990. Foreword. In: Burton, S.W. & Akiskal. H.S. (Eds) Dysthymic disorder. London: Gaskell, pp. xi-xii.
Katona, C.L.E. 1990. Clinical features in depression and bereavement in old age. Current Opinion in Psychiatry, 3: 512-15.
Katona, C.L.E. & Bell, G.T. 1990. Depression and dysthymia in old age. In: Burton, S.W. & Akiskal. H.S. (Eds) Dysthymic disorder. London: Gasket I,
pp. 49-68.
Keller, M.B. & Sessa. F.M. 1990, Dysthymia: development and clinical course. In: Burton, S.W. & Akiskal, H.S. (Eds) Dysthymic disorder. London: Gaskell, pp. 13-23.
Kennedy, G.J., Kelman, H.R., & Thomas, C. et al. 1989. Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. American Journal of Psychiatry, 146(2): 220-25.
Lindesay, J. 1990. The Guy's/Age Concern Survey: physical health and psychiatric disorder in an urban elderly community. International Journal of Geriatric Psychiatry. 5: 171-78.
Lloyd, C, 1980. Life events and depressive disorder reviewed. Part 1. Events as predisposing factors. Archives of General Psychiatry, 37: 529-35.
Morris, J.W. 1975. Uses of epidemiology. Third edition. Edinburgh: Churchill Livingstone.
Murphy, E. 1982. Social origins of depression in old age. British Journal of Psychiatry. 144: 135-42.
Murphy, E. 1989. Depression in the elderly. In: Herbst, K.R. & Paykel, E.S. (Eds) Depression — an integrative approach. Heinemann Medical Books and The Mental Health Foundation.
Murphy, E., Lindesay, J. & Grundy, E. 1986. Sixty years of suicide in England and Wales. Archives of General Psychiatry, 43: 969-77.
Neugarten, B.C., Havighurst. R.J. & Tobin, S.S. 1961. The measurement of life satisfaction. Journal of Gerontology, 16: 134-42.
Oxman, T.E., Barrett, J.E. & Barrett, J. 1990. Symptomatology of late-life minor depression among primary care patients. Psychosomatics, 31: 174-80.
Pfifer, J.F. & Murrell, S.A. 1986. Etiologic factors in the onset of depressive symptoms in older adults. Journal of Abnormal Psychology, 95: 282-91.
Pitt, B. 1982. Psychogeriatrics: an introduction to the psychiatry of old age. Second edition. Edinburgh: Churchill Livingstone.
Rihmer, Z. 1990. Dysthymia: a clinician's perspective. In: Burton, S.W. & Akiskal. H.S. Dysthymic disorder. London: Gaskell, pp. 112-25.
Walton, V., Romans-Clarkson, S., Mullen, P. et al. 1990. The mental health of elderly women in the community. International Journal of Geriatric Psychiatry, 5: 257-63.
Webb, L.J., DiClemente, C.C., Johnstone, E.E., Sanders, J.L. & Perley, R.A. 1981. DSM-III Training Guide. New York: Brunner/Mazel.
Wilson, K.C.M. 1991. Epidemiology, risk factors and clinical features. Current Opinion in Psychiatry, 4: 587-90.
Wilson, K.C.M. & Copeland, J.R.M. 1990. Epidemiology, risk factors and clinical features. Current Opinion in Psychiatry, 3: 516-21.
American Psychiatric Association. 1987. Diagnostic and Statistical Manual of Mental Disorders. Edition III Reused. (DSM-III-R.) Washington.
Angst, J., Merikangas, K., Scheidegger, P. & Wicki, W. 1990. Recurrent brief depression: a new subtype of affective disorders. Journal of Affective Disorders, 19: 87-98.
Barnes, J.M. & Yach, D. 1991. A survey of health aspects of black elderly living in a settled and newly developed township in the Cape Metropolitan area. Cape Town: Medical Research Council. Urbanisation and Health National Programme, Technical Report. No 2.
Ben-Arie, O., Swartz, L,, Teggin. A.F. & Elk, R. 1983. The Coloured elderly in Cape Town - a psychosocial, psychiatric and medical community survey. Part 2. Prevalence of psychiatric disorders. South African Medical Journal, 64: 1056-61.
Blazer, D.G. 1989a. The epidemiology of psychiatric disorders in late life. In: Busse, D.G. & Blazer, D.G, (Eds) Geriatric psychiatry. Washington: American Psychiatric Press, pp. 235-60.
Blazer, D.G. 1989b. Affective disorders in late life. In: Busse. E. W. & Blazer. D.G. (Eds) Geriatric psychiatry. Washington: American Psychiatric Press, pp. 369-401.
Blazer, D.G. 1991. Clinical features in depression in old age: a case for minor depression. Current Opinion in Psychiatry. 4: 596-99.
Blazer. D., Woodbury, M. & Hughes. D.C. et al. 1989. A statistical analysis of the classification of depression in a mixed community and clinical sample. Journal of Affective Disorders. 16: 11-20.
Copeland, J.R.M., Gurland. B.J. & Dewey, M.E. 1987. Is there more dementia. depression and neurosis in New York? A comparative community study of the elderly in New York and London using the community diagnosis AGECAT. British Journal of Psychiatry. 151: 466-73,
Gillis, L.S., Elk, R., Trichard, L., Le Fevre, K., Zabow. A., Joffe, H. & van Schalkwyk, D.J. 1982. The admission of the elderly to places of care: a socio-psychiatric community survey. Psychological Medicine, 12: 15968.
Gillis, L.S., Welman, M., Koch, A. & Joyi, M. 1991. Psychological distress and depression in urbanising elderly black persons. South African Medical Journal, 79(8): 490-95.
Gillis, L.S. & Zabow, A. 1982. Dysphoria in the elderly. South African Medical Journal, 62: 410-13.
Hamilton, M. 1960. Rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23:56-62.
Hamilton, M. 1990. Foreword. In: Burton, S.W. & Akiskal. H.S. (Eds) Dysthymic disorder. London: Gaskell, pp. xi-xii.
Katona, C.L.E. 1990. Clinical features in depression and bereavement in old age. Current Opinion in Psychiatry, 3: 512-15.
Katona, C.L.E. & Bell, G.T. 1990. Depression and dysthymia in old age. In: Burton, S.W. & Akiskal. H.S. (Eds) Dysthymic disorder. London: Gasket I,
pp. 49-68.
Keller, M.B. & Sessa. F.M. 1990, Dysthymia: development and clinical course. In: Burton, S.W. & Akiskal, H.S. (Eds) Dysthymic disorder. London: Gaskell, pp. 13-23.
Kennedy, G.J., Kelman, H.R., & Thomas, C. et al. 1989. Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. American Journal of Psychiatry, 146(2): 220-25.
Lindesay, J. 1990. The Guy's/Age Concern Survey: physical health and psychiatric disorder in an urban elderly community. International Journal of Geriatric Psychiatry. 5: 171-78.
Lloyd, C, 1980. Life events and depressive disorder reviewed. Part 1. Events as predisposing factors. Archives of General Psychiatry, 37: 529-35.
Morris, J.W. 1975. Uses of epidemiology. Third edition. Edinburgh: Churchill Livingstone.
Murphy, E. 1982. Social origins of depression in old age. British Journal of Psychiatry. 144: 135-42.
Murphy, E. 1989. Depression in the elderly. In: Herbst, K.R. & Paykel, E.S. (Eds) Depression — an integrative approach. Heinemann Medical Books and The Mental Health Foundation.
Murphy, E., Lindesay, J. & Grundy, E. 1986. Sixty years of suicide in England and Wales. Archives of General Psychiatry, 43: 969-77.
Neugarten, B.C., Havighurst. R.J. & Tobin, S.S. 1961. The measurement of life satisfaction. Journal of Gerontology, 16: 134-42.
Oxman, T.E., Barrett, J.E. & Barrett, J. 1990. Symptomatology of late-life minor depression among primary care patients. Psychosomatics, 31: 174-80.
Pfifer, J.F. & Murrell, S.A. 1986. Etiologic factors in the onset of depressive symptoms in older adults. Journal of Abnormal Psychology, 95: 282-91.
Pitt, B. 1982. Psychogeriatrics: an introduction to the psychiatry of old age. Second edition. Edinburgh: Churchill Livingstone.
Rihmer, Z. 1990. Dysthymia: a clinician's perspective. In: Burton, S.W. & Akiskal. H.S. Dysthymic disorder. London: Gaskell, pp. 112-25.
Walton, V., Romans-Clarkson, S., Mullen, P. et al. 1990. The mental health of elderly women in the community. International Journal of Geriatric Psychiatry, 5: 257-63.
Webb, L.J., DiClemente, C.C., Johnstone, E.E., Sanders, J.L. & Perley, R.A. 1981. DSM-III Training Guide. New York: Brunner/Mazel.
Wilson, K.C.M. 1991. Epidemiology, risk factors and clinical features. Current Opinion in Psychiatry, 4: 587-90.
Wilson, K.C.M. & Copeland, J.R.M. 1990. Epidemiology, risk factors and clinical features. Current Opinion in Psychiatry, 3: 516-21.
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1992-10-01
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