Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-28T12:39:22.864Z Has data issue: false hasContentIssue false

Depression Before and After Age 65

A Re-examination

Published online by Cambridge University Press:  02 January 2018

Laura Musetti
Affiliation:
Institute of Clinical Psychiatry, University of Pisa
Giulio Perugi
Affiliation:
Institute of Clinical Psychiatry, University of Pisa
Adalgisa Soriani
Affiliation:
Institute of Clinical Psychiatry, University of Pisa
Vedia M. Rossi
Affiliation:
Institute of Clinical Psychiatry, University of Pisa
Giovanni B. Cassano*
Affiliation:
Institute of Clinical Psychiatry, University of Pisa
Hagop S. Akiskal
Affiliation:
University of Tennessee
*
Via Roma 67, 56100 Pisa, Italy

Abstract

Systematic and detailed psychopathological examination of 400 consecutive primary major depressives failed to confirm common clinical stereotypes which ascribe greater somatisation, hypochondriasis, agitation, psychotic tendencies, and chronicity to old age. Those above 65 were more likely to suffer from single episodes of depression that were often precipitated, whereas subjects whose illness began earlier were more likely to express depression as part of a recurrent unipolar or bipolar disorder, with higher rates of affective temperamental pathology and familial affective illness. The acute clinical picture was relatively uniform in older and younger depressives and, taken together with the other findings, tends to favour a spectrum model of primary mood disorders.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, H. S. (1982) Factors associated with incomplete recovery in primary depressive illness. Journal of Clinical Psychiatry, 43, 266271.Google Scholar
Akiskal, H. S. (1983a) Diagnosis and classification of affective disorders: new insights from clinical and laboratory approaches. Psychiatric Developments, 2, 123160.Google Scholar
Akiskal, H. S. (1983b) The bipolar spectrum: new concepts in classification and diagnosis In Psychiatry Update: the American Psychiatric Association Annual Review, Vol. 2 (ed.) L. Grinspoon. Washington, DC: American Psychiatric Press.Google Scholar
Akiskal, H. S., Walker, P. W., Puzantian, V. R., et al (1983) Bipolar outcome in the course of depressive illness: phenomenologic, familial and pharmacological predictors. Journal of Affective Disorders, 5, 115128.Google Scholar
Akiskal, H. S. & Mallya, G. (1987) Criteria for the soft bipolar spectrum: treatment implications. Psychopharmacology Bulletin, 23, 6873.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised). Washington, DC: American Psychiatric Press.Google Scholar
Andreasen, N. C., Endicott, J., Spitzer, R. L., et al (1977) The family history method using diagnostic criteria. Archives of General Psychiatry, 34, 12291235.CrossRefGoogle ScholarPubMed
Angst, J. (1966) Zur atiologie und nosologie endogener depressiver psycosen. Monographien aus dem Gesamtgebiete der Neurologie und Psychiatrie, 112, 1118. Berlin: Springer Verlag.Google Scholar
Blazer, O. & Williams, C. D. (1980) Epidemiology of dysphoria and depression in an elderly population. American Journal of Psychiatry, 137, 439444.Google Scholar
Busse, E. W. & Blazer, D. G. (1980) Disorders related to biological functioning. Handbook of Geriatric Psychiatry. New York: Van Nostrand Reinhold.Google Scholar
Cassano, G. B., Musetti, L., Perugi, G., et al (1987) Major depression subcategories: their potentiality for clinical research. Diagnosis and treatment of depression In Diagnostic et Traitement de la Dépression (eds K. Biziére, S. Garattini & P. Simon). Montpellier: Sanofi Recherche.Google Scholar
Ciompi, L. (1969) Follow-up studies in the evolution of former neurotic and depressive states. Journal of Geriatric Psychiatry, 3, 90106.Google Scholar
Coryell, W., Endicott, J., Andreasen, N., et al (1985) Bipolar I, bipolar II, and nonbipolar major depression among the relatives of affectively ill probands. American Journal of Psychiatry, 142, 817823.Google ScholarPubMed
Depeu, R. A. & Monroe, S. M. D. (1978) The unipolar-bipolar distinction in the depressive disorders. Psychological Bulletin, 85, 10011009.Google Scholar
Derogatis, L. R., Lipman, R. S. & Rickels, S. K. (1973) The Hopkins Symptoms Checklist (HSCL): a measure of primary symptoms dimensions in psychological measurement In Modern Problems Pharmacopsychiatry (ed.) P. Pichot. Basel: Karger.Google Scholar
Finlayson, R. E. & Martin, L. M. (1982) Recognition and management of depression in the elderly. Mayo Clinic Proceedings, 57, 115120.Google Scholar
Glasser, M. & Rabins, P. (1984) Mania in the elderly. Age and Aging, 13, 210213.Google Scholar
Goldfarb, A. I. (1967) Masked depression in the old. American Journal of Psychotherapy, 21, 791803.Google Scholar
Goldstein, S. E. (1979) Depression in the elderly. Journal of American Geriatric Society, 27, 3842.CrossRefGoogle ScholarPubMed
Gurland, B. (1976) The comparative frequency of depression in various adult age groups. Journal of Gerontology, 31, 283292.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social Clinical Psychology, 6, 278296.CrossRefGoogle ScholarPubMed
Hopkinson, G. E. & Ley, P. (1969) A genetic study of affective disorder. British Journal of Psychiatry, 115, 917922.Google Scholar
Jacoby, R. J., Levy, R., & Bird, J. M. (1981) Computed tomography and the outcome of affective disorders: a follow-up study of patients. British Journal of Psychiatry, 139, 288292.Google Scholar
Katon, W. (1982) Depression: somatic symptoms and medical disorders in primary care. Comprehensive Psychiatry, 23, 274287.Google Scholar
Kukull, W. A., Koepsell, T. D., Inui, T. S., et al (1986) Depression and physical illness among elderly general medical clinic patients. Journal of Affective Disorders, 10, 153162.CrossRefGoogle ScholarPubMed
Mendlewicz, J. (1976) The age factor in depressive illness: some genetic considerations. Journal of Gerontology, 31, 300303.CrossRefGoogle ScholarPubMed
Murphy, E. (1982) Social origins of depression in old age. British Journal of Psychiatry, 141, 135142.Google Scholar
Murphy, E. (1983) The prognosis of depression. British Journal of Psychiatry, 142, 111119.CrossRefGoogle ScholarPubMed
Nielsen, A. C. & Williams, T. A. (1980) Depression in ambulatory medical patients: prevalence by self report questionnaire and recognition by nonpsychiatric physicians. Archives of General Psychiatry, 37, 9991004.Google Scholar
Pichot, P. & Pull, C. (1981) Is there an involutional melancholia? Comprehensive Psychiatry, 22, 210.CrossRefGoogle ScholarPubMed
Placidi, G. F., Rampello, E. & Cassano, G. B. (1984) La depressione nell'età senile: aspetti clinici e terapeutici. Quaderni Italiani di Psichiatria, III, 336.Google Scholar
Post, F. (1987) Depression, alcoholism, and other functional syndromes In Psychogeriatrics - an International Handbook (ed.) M. Bergener. New York: Springer Publishing Company.Google Scholar
Roth, M. (1976) The psychiatric disorders of later life. Psychiatric Annals. 6, 57101.CrossRefGoogle Scholar
Saltzman, C. & Shader, R. I. (1978) Depression in the elderly - I. Relationship between depression, psychologic defense mechanism and physical illness. Journal of American Geriatric Society, 26, 253260.Google Scholar
Schneider, K. (1958) Psychopathic Personalities (trans, by Hamilton, M. W.). London: Cassell.Google Scholar
Shamoian, C. A. (1985) Assessing depression in elderly patients. Hospital and Community Psychiatry, 36, 338339.Google ScholarPubMed
Shulman, K. & Post, F. (1980) Bipolar affective disorder in old age. British Journal of Psychiatry, 136, 2632.CrossRefGoogle ScholarPubMed
Steuer, J., Bank, L., Olsen, E. J., et al (1980) Depression, physical health, and somatic complaints in the elderly: a study of the Zung Self-Rating Depression Scale. Journal of Gerontology, 35, 683688.Google Scholar
Widlöcher, D. (1983) Psychomotor retardation: clinical, theoretical, and psychometric aspects. Psychiatric Clinics of North America, 6, 2740.Google Scholar
Winokur, G., Morrison, J., Clancy, J., et al (1973) The Iowa 500: familial and clinical findings favor two kinds of depressive illness. Comprehensive Psychiatry, 14, 99107.Google Scholar
Winokur, G., Behan, D. & Schlesser, M. (1980) Clinical and biological aspects of depression in the elderly In Psychopathology in the Aged (eds J O. Cole & J. E. Barrett). New York: Raven Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.