Depression in older adults.
Depression in older adults.
复制标题
DOI：
10.1146/annurev.clinpsy.032408.153621
复制
发表时间：
2009
影响因子：
18.4
通讯作者：
Gatz M
中科院分区：
文献类型：
--
作者：
Fiske A;Wetherell JL;Gatz M
抑郁症在老年人中不像在年轻人中那么普遍，但会产生严重的后果。一半以上的病例是在以后的生活中首次发病。尽管老年人的自杀率正在下降，但仍高于年轻人，而且与抑郁症的关系更密切。与年轻人相比，抑郁的老年人不太可能出现情感症状，更可能表现出认知变化、躯体症状和兴趣丧失。导致老年抑郁症发展的风险因素可能包括遗传脆弱性、认知素质、年龄相关的神经生物学变化和压力事件之间复杂的相互作用。失眠是导致晚年抑郁的一个经常被忽视的风险因素。我们认为，老年人抑郁的一个共同途径可能是减少日常活动，无论哪种易感风险最突出。伴随的自我批判思维可能会加剧和维持抑郁状态。抵消某些风险因素在晚年日益普遍的是与年龄相关的心理弹性的增加。其他保护因素包括高等教育和社会经济地位，参与有价值的活动，宗教或精神参与。包括行为疗法、认知行为疗法、认知阅读疗法、问题解决疗法、简短心理动力疗法和生活回顾/回忆疗法在内的治疗方法对老年人有效，但很少用于老年人。预防干预措施包括对慢性疾病患者的教育、行为激活、认知重组、解决问题的技能培训、团体支持和生活回顾也得到了支持。
Depression is less prevalent among older adults than among younger adults but can have serious consequences. Over half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are younger adults. Risk factors leading to the development of late life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support.
登录
查看更多内容
影响因子：
3.4
作者：
Andrew, D. H.;Dulin, P. L.
通讯作者：
Dulin, P. L.
影响因子：
3.7
作者：
Areán, PA;Gum, A;Thompson, L
通讯作者：
Thompson, L
影响因子：
120.7
作者：
Bruce, ML;Ten Have, TR;Alexopoulos, GS
通讯作者：
Alexopoulos, GS
影响因子：
3.7
作者：
Benyamini, Y;Lomranz, J
通讯作者：
Lomranz, J
影响因子：
17.7
作者：
Bruce, ML;McAvay, GJ;Weber, C
通讯作者：
Weber, C