Depression in the Elderly. I. Relationship between Depression, Psychologic Defense Mechanisms and Physical Illness*

Salzman, Carl; Shader, Richard I.

doi:10.1111/j.1532-5415.1978.tb02398.x

Cited by 99 publications

(67 citation statements)

References 24 publications

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“…Surprisingly, the presence of heart disease was not associated with an increase in the prevalence of depressive illness in this population, despite the implications for the future such a diagnosis would seem to imply. Salzman and Shader (1978) reported that 'cardiac illness regularly produces severe depression', but even those in this sample complaining of current problems, i.e. angina, did not have an increased rate of depressive illness.…”

Section: Discussionmentioning

confidence: 75%

Depression in the elderly in the community: Effect of physical illness and selected social factors

Evans¹,

Copeland²,

Dewey³

1991

Int J Geriat Psychiatry

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SUMMARYDepressive illness in the elderly may be the result of a physical illness, the cause of secondary physical problems, coincidental to physical illness or the result of an aetiological factor common to both conditions. Analysis of a cross-sectional community sample of 396 elderly people showed depression to be significantly linked to presence of headaches, dyspnoea, and malignant disease known to the patient. It was not linked with heart disease nor arthritis per se, although those on anti-arthritic or analgesic medication were significantly more depressed. The subjective description of physical health given by the patient also correlated strongly with depression.Depressive illness is sometimes unrecognized and frequently untreated with a consequent reduction in quality of life for many patients. Clinicians must be aware of the possibility that depression may coexist with physical illness, and that both conditions may need appropriate treatment.Further analysis of the above sample, controlling for physical illness and the additive effect of the variables concerned, showed depression to be positively correlated with adverse social factors such as not going out because of physical disability, feeling lonely, having a shopper and having hearing difficulties. The home help service was identified as a probable protective factor, implying the importance of this service in supporting the emotional as well as the physical needs of its clients.KEY WORDS-Depression, elderly, physical illness, social factors, liaison psychiatry.Depressive illness is a relatively common disorder in the elderly. Community studies have shown prevalence of 11.5% (Copeland et al., 1987) to 26.2% (Kay et al., 1964); first admission rates for depressive illness reach a peak in the sixth and seventh decades (Post, 1976), although first diagnosis of the illness occurs with decreasing frequency after the age of 65. It thus appears that the more severe kinds of depressive illness are most frequently seen in the elderly (Post, 1982). In residential homes, prevalence reaches a worrying 40% (Ames et al., 1988) and in home-care and sheltered

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Section: Discussionmentioning

confidence: 75%

Depression in the elderly in the community: Effect of physical illness and selected social factors

Evans¹,

Copeland²,

Dewey³

1991

Int J Geriat Psychiatry

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“…In the United States, although this age group represents about 11% of the population, it has the highest suicide rate and accounts for 17% of all suicides [Jefferson, 1983]. As many as 5-10% of the population age 65 or older are depressed [Salzman and Shader, 1978]. In addition, bipolar disorder accounts for 5-19% of mood disorders found in older adults [Cassano et al, 2000], and 5% of psychiatric hospitalizations after the age of 60 are due to mania [Young and Klerman, 1992].…”

Section: Introductionmentioning

confidence: 99%

Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation

et al. 2007

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Affective disorders are a major cause of morbidity and disability among middle-aged and older people. Thus, the prophylaxis of both unipolar depression and bipolar disorder in this patient subpopulation is an important task of psychiatrists and other physicians. Although lithium remains an effective prophylactic and treatment agent in younger individuals with bipolar disorder, its prophylactic efficacy and tolerability has not been thoroughly investigated among middle aged and older people with unipolar depression and bipolar disorder. Our study is based on a mirror-image design that compared the clinical course with lithium treatment and the clinical course prior to lithium treatment based on a retrospective chart review. We examined the results obtained with long-term lithium maintenance in a group of 60 middle-aged and older adult patients (age >60 years) with unipolar depression and bipolar disorder. More specifically, we analyzed changes of frequency, severity, and duration of depressive or manic relapses, rate and duration of hospitalizations and suicidal behavior (thoughts or attempts), and various assessments of outcome. A significant reduction was found on all indices during lithium therapy compared to before lithium treatment, attesting to the prophylactic efficacy of long-term lithium in unipolar depression and bipolar disorder. The range of side effects in our sample was similar to that found in other reports in this age group. The probability of relapse and recurrence in patients with bipolar disorder and with unipolar depression can be significantly decreased by lithium prophylaxis. Further investigation is mandated to confirm these findings under double-blind conditions.

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“…Though difficult to assess, some authorities believe depression is the most prevalent mental dysfunction in older adults (Epstein, 1976;Gurland, 1976;Salzman & Shader, 1978;Zarit, 1980). The prevalence of depression and the high suicide rate among older adults (Miller, 1979;Wenz, 1980) appears to warrant further study of depression in adults of this age group.…”

mentioning

confidence: 99%

Group counseling as an intervention in anger expression and depression in older adults

Johnson¹,

Wilborn

1991

The Journal for Specialists in Group Work

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Depression in the Elderly. I. Relationship between Depression, Psychologic Defense Mechanisms and Physical Illness*

Cited by 99 publications

References 24 publications

Depression in the elderly in the community: Effect of physical illness and selected social factors

Depression in the elderly in the community: Effect of physical illness and selected social factors

Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation

Group counseling as an intervention in anger expression and depression in older adults

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