Treatment of depression in the elderly: A Canadian view

Ancill, R. J.; Holliday, Stephen G.

doi:10.1016/0278-5846(90)90036-g

Cited by 8 publications

(6 citation statements)

References 6 publications

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“…The prevalence of depression in patients aged ≥ 65 years may be as high as 40% in hospitalised and nursing home patients, and 8–15% in community settings [5]. Depression in the elderly is associated with an increased risk of mortality, dementia and substantial psychosocial disability [6], resulting in an economic burden of $15 billion in Australia [7] and $83 billion in the United States [8]. …”

Section: Introductionmentioning

confidence: 99%

Psychometric properties of a short form of the Center for Epidemiologic Studies Depression (CES-D-10) scale for screening depressive symptoms in healthy community dwelling older adults

Mohebbi

Nguyen

McNeil

et al. 2018

General Hospital Psychiatry

151

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Background: The 10-item Center for the Epidemiological Studies of Depression Short Form (CES-D-10) is a widely used self-report measure of depression symptomatology. The aim of this study is to investigate the psychometric properties of the CES-D-10 in healthy community dwelling older adults. Methods: The sample consists of 19,114 community-based individuals residing in Australia and the United States who participated in the ASPREE trial baseline assessment. All individuals were free of any major illness at the time. We evaluated construct validity by performing confirmatory factor analysis, examined measurement invariance across country and gender followed by evaluating item discrimination bias in age, gender, race, ethnicity and education level, and assessing internal consistency. Results: High item–total correlations and Cronbach’s alpha indicated high internal consistency. The factor analyses suggested a unidimensional factor structure. Construct validity was supported in the overall sample, and by country and gender sub-groups. The CES-D-10 was invariant across countries, and although evidence of marginal gender non-invariance was observed there was no evidence of notable gender specific item discrimination bias. No notable differences in discrimination parameters or group membership measurement non-invariance were detected by gender, age, race, ethnicity, and education level. Conclusion: These findings suggest the CES-D-10 is a reliable and valid measure of depression in a volunteer sample. No noteworthy evidence of invariance and/or item discrimination bias is observed across gender, age, race, language and ethnic groups.

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Section: Introductionmentioning

confidence: 99%

Psychometric properties of a short form of the Center for Epidemiologic Studies Depression (CES-D-10) scale for screening depressive symptoms in healthy community dwelling older adults

Mohebbi

Nguyen

McNeil

et al. 2018

General Hospital Psychiatry

151

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“…Although ECT is recommended for elderly patients with severe, psychotic, or treatment‐resistant depression, 1,2 further modification of drug therapy tends to be attempted in patients that exhibit some benefit from medication, possibly prolonging the period of depression, as in the present patients. Furthermore, the pseudohysterical symptoms were one of the factors in the postponement of the decision to perform ECT, since we were unsure whether ECT would improve all the symptoms; we thought that ECT might be ineffective in treating hysteria.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with senile depression can quickly and easily develop a physically critical condition because of the adverse effects of antidepressants, including gastrointestinal symptoms and extrapyramidal symptoms as well as anorexia caused by the depression itself, and often suffer from prolonged periods of depression. Electroconvulsive therapy (ECT) has been recommended for the treatment of such cases; 1,2 however, deciding how long to wait for the onset of the antidepressant effects and when to start ECT can be difficult. In the present paper, two elderly patients with depression who developed pseudohysterical symptoms, 3 which confused the diagnostic process and consequently prolonged their depression, and their successful treatment using a modified ECT procedure are described.…”

Section: Introductionmentioning

confidence: 99%

Effect of electroconvulsive therapy for the treatment of senile depression with marked pseudohysterical symptoms

et al. 2004

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Two elderly patients with prolonged depression and prominent pseudohysterical symptoms were successively treated using electroconvulsive therapy (ECT). Patient 1, a 71-year-old woman, developed depression in anticipation of her husband's retirement from his post as a college president and his receiving of a civilian decoration. She became bedridden because of the adverse effects of the antidepressants, and she was admitted to our hospital. Initial treatment was efficacious to some extent; however, after moving from a private room to an eight-person ward, she began to exhibit passiveaggressive behavior and seemed to seek attention. Her diagnosis and treatment was difficult, but ECT relieved her symptoms. Patient 2, a 74-year-old man, developed depression after experiencing domestic trivialities. Treatment as an outpatient produced numerous adverse effects and was of little effect, so the patient was admitted to hospital. As was seen in patient 1, this patient was moved to a ward room after he showed an initial improvement, but his condition deteriorated and he began to show passive-aggressive behavior; ECT also relieved his symptoms. A multidisciplinary strategy, including ECT during the early period of treatment, might be effective for the treatment of senile depression.

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“…Some elderly patients with severe depressive symptoms appear to be resistant to the antidepressant effects of medications and should be considered for treatment with electroconvulsant therapy ( E m . In one centre about 25% of depressed patients admitted to an in-patient programme required ECT because of severity of illness with psychosis, active suicidal ideas or because of lack of response or tolerance to drug therapy (49).…”

Section: Adverse Effects Of Antidepressantsmentioning

confidence: 99%

“…Monoamine oxidase inhibitors (MAOIs), which inhibit the degradation of both norepinephrine and serotonin, appear to be as effective as cydic antidepressants in treating depression in the elderly (49,50). MAOIs are prone to cause orthostatic hypotension and are involved in many drug-drug and d r u g -f d interactions that may lead to severe hypertensive reactions.…”

mentioning

confidence: 99%

Advances in pharmacotherapy: depression in the elderly– issues and advances in treatment

Stewart

1993

J Clin Pharm Ther

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SUMMARYDepression continues to be a major cause of morbidity and mortality in the elderly. It is estimated that 1-546 of elderly persons who live in the community and 5-4370 of nursing-home patients have major depression. Symptoms of depression in the elderly do not differ substantiaIIy from younger patients. Tricyclic antidepressants continue to be the drugs of choice in the elderly because of their long record of use with proven efficacy, known adverse effect profile and availability of less expensive generic formulations. The newer secondgeneration antidepressants, including serotonin reuptake inhibitors, appear to offer a major advantage of fewer serious adverse effects in the elderly. This review will highlight recent developments regarding the prevalence and treatment of depression in the elderly.

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Treatment of depression in the elderly: A Canadian view

Cited by 8 publications

References 6 publications

Psychometric properties of a short form of the Center for Epidemiologic Studies Depression (CES-D-10) scale for screening depressive symptoms in healthy community dwelling older adults

Psychometric properties of a short form of the Center for Epidemiologic Studies Depression (CES-D-10) scale for screening depressive symptoms in healthy community dwelling older adults

Effect of electroconvulsive therapy for the treatment of senile depression with marked pseudohysterical symptoms

Advances in pharmacotherapy: depression in the elderly– issues and advances in treatment

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