Late Life Recurrent Depression: Challenge to Mental Health Care.

N

14

Counseling; Depression (Psychology); Emotional Problems; Health; Health Maintenance Organizations; Health Promotion; Health Services; Mental Health; Older Adults; Psychological Patterns; Sadness; Therapy

For the vast majority of persons of all ages who suffer from major depression, it is recurrent. A traditional wisdom has been that elderly persons respond more poorly to treatment for serious depression than younger persons. The psychiatric status of 127 elderly persons hospitalized for an episode of major depression was systematically assessed for one year. The rates of recovery and relapse were virtually identical to studies of younger patients. However, almost three quarters of this group of older people had recurrent depression, and a year after hospitalization, only one-third were symptom free. More vigorous antidepressant medication treatment of late life depressive illness to prevent recurrence was advocated at the National Institute of Health Consensus Conference on Late Life Depression. Some geropsychologists were outraged at the almost exclusive emphasis on somatic intervention. Unfortunately, well designed psychological intervention studies for depression are few in number. It is suggested that psychotherapeutic treatments for depression with demonstrated efficacy in younger people can be productively applied to older adults. The Geriatric Psychiatry Division at Long Island Jewish Medical Center is described as it presents one model of a continuum of care, with psychologists playing an important role in the system. Contains 23 references. (JBJ)

1996

ED393039