Depression Among Older Adults: A 20-Year Update on Five Common Myths and Misconceptions
Depression Among Older Adults: A 20-Year Update on Five Common Myths and Misconceptions
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DOI：
10.1016/j.jagp.2017.06.011
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发表时间：
2018-01-01
影响因子：
7.2
通讯作者：
Blazer, Dan G.
中科院分区：
文献类型：
--
作者：
Haigh, Emily A. P.;Bogucki, Olivia E.;Blazer, Dan G.
老年人的抑郁症与年轻人的抑郁症有什么不同吗？它是更常见、慢性还是更难治疗？老年抑郁症更可能归因于心理问题吗？20年前，丹·布莱泽（Dan Blazer）是一位以其在老年抑郁症方面的开创性工作而闻名的先驱，他对现有文献进行了一次重要的回顾，驳斥了五种关于老年抑郁症的普遍看法。现在，二十年后，我们呼吁选定的文章，是我们目前的知识代表，提供更新，并确定研究的优先事项。过去20年的研究共识表明，与年轻人相比，老年人的抑郁症并不常见，也不经常由心理因素引起。尽管一些研究表明，晚年的抑郁症可能在病理学上有所不同，其特征是更躯体化的表现，但没有足够的经验证据得出结论，抑郁症在成年期表现不同。总的来说，老年人和年轻人一样对心理干预有反应，尽管有证据表明抗抑郁药在晚年的疗效较低。最后，与中年人相比，老年人的抑郁症与更慢性的病程有关（即，复发率较高），这可能受医学合并症的影响。这篇特别的文章总结了我们目前对晚年抑郁症的性质和治疗的理解，并强调了需要进一步研究的调查领域。
Is depression among older adults symptomatically different than younger adults? Is it more common or chronic or difficult to treat? Is depression in late life more likely to be attributed to psychological problems? Twenty-years ago, Dan Blazer, a pioneer known for his groundbreaking work on depression in older adulthood, conducted an important review of the existing literature to refute five commonly held beliefs about depression in late life. Now, two decades later, we call upon selected articles that are representative of our current knowledge to provide an update and identify research priorities. The research consensus spanning the past 20 years suggests that when compared with their younger counterparts, depression in older adults is not more common and is not more often caused by psychological factors. Although some studies have suggested that depression in late life may be symptomatically different and characterized by a more somatic presentation, there is insufficient empirical evidence to conclude that depression presents differently across adulthood. Overall, older adults respond to psychological interventions as well as younger adults, although evidence suggests that antidepressants are less efficacious in late life. Finally, compared with middle-aged adults, depression in older adults is associated with a more chronic course (i.e., higher rate of relapse), which is likely moderated by medical comorbidity. This special article summarizes our current understanding of the nature and treatment of late-life depression and highlights areas of inquiry in need of further study.