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Article
August 26, 1992

Diagnosis and Treatment of Depression in Late Life

Author Affiliations

Panel and Conference Chairperson, Professor, Department of Psychiatry, Director, Millhauser Laboratories, New York University School of Medicine, New York, NY; Chairman and Professor, Department of Psychiatry and Behavioral Sciences, Director, Institute of Psychiatry, Medical University of South Carolina, Charleston; Professor of Psychiatry, Director of Clinical Psychology, East Pennsylvania Psychiatric Institute, Medical College of Pennsylvania, Philadelphia; Director, Maryland Psychiatric Research Center, Professor of Psychiatry and Pharmacology, Department of Psychiatry, University of Maryland School of Medicine, Baltimore; Associate Professor of Neurology, Geriatric Neurobehavior and Alzheimer Center, Rancho Los Amigos Medical Center, University of Southern California, Los Angeles; Director, Brookdale Center on Aging, Hunter College, New York, NY; Professor and Dean of Nursing, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio; Private Practice in Geriatric Psychiatry, Medical Director, Adult Inpatient Unit, Riverside Regional Medical Center, Newport News, Va; Associate Chairman for Research, Professor of Psychiatry, Yale University School of Medicine, New Haven, Conn; Associate Chairman for Research, Department of Psychiatry and Human Behavior, Brown University, Providence, RI; Director, Genetic Epidemiology Research Unit, Associate Professor of Psychiatry and Epidemiology, Yale University School of Medicine, New Haven, Conn; Director of Elderly Services, Spokane Community Mental Health Center, Spokane, Wash; Professor of Psychology, Department of Psychology, Washington University, St Louis, Mo; Associate Professor of Medicine, Director, Program on Aging, University of North Carolina School of Medicine, Chapel Hill; Planning Committee Cochairperson, Chief, Mental Disorders of the Aging Research Branch, Division of Clinical Research, National Institute of Mental Health Alcohol, Drug Abuse, and Mental Health Administration, Rockville, Md; Planning Committee Cochairperson, Professor of Psychiatry and Neurology, Western Psychiatric Institute and Clinic, University of Pittsburgh (Pa); Planning Committee Cochairperson, Associate Professor of Psychiatry and Neurology, University of Southern California, Los Angeles; Senior Scientific Adviser, National Institute of Mental Health Alcohol, Drug Abuse, and Mental Health Administration, Rockville, Md; Professor of Psychiatry and Neurology, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY; Director, Office of Scientific Information, National Institute of Mental Health Alcohol, Drug Abuse, and Mental Health Administration, Rockville, Md; Program Analyst, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Director, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Chief, Longitudinal Studies Branch, National Institute on Aging Gerontology Research Center, National Institutes of Health, Baltimore, Md; Panel and Conference Chairperson, Professor, Department of Psychiatry, Director, Millhauser Laboratories, New York University School of Medicine, New York, NY; Professor, Department of Psychiatry, Duke University Medical Center, Durham, NC; Director of Communications, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Professor of Psychiatry, Director, Division of Geriatric Psychiatry, Medical College of Pennsylvania, Philadelphia; Head, Geriatric Treatment Research, Mental Disorders of the Aging Research Branch, Division of Clinical Research, National Institute of Mental Health Alcohol, Drug Abuse, and Mental Health Administration, Rockville, Md; Research Psychologist, Mental Disorders of the Aging Research Branch, Division of Clinical Research, National Institute of Mental Health Alcohol, Drug Abuse, and Mental Health Administration, Rockville, Md; Professor and Chairman, Department of Psychiatry and Behavioral Medicine, The Bowman Gray School of Medicine, Winston-Salem, NC; Associate Professor, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
From the Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md.

JAMA. 1992;268(8):1018-1024. doi:10.1001/jama.1992.03490080092032
Abstract

DEPRESSION in the aging and the aged is a major public health problem. It causes suffering to many who go undiagnosed, and it burdens families and institutions providing care for the elderly by disabling those who might otherwise be able-bodied. What makes depression in the elderly so insidious is that neither the victim nor the health care provider may recognize its symptoms in the context of the multiple physical problems of many elderly people. Depressed mood, the typical signature of depression, may be less prominent than other depressive symptoms such as loss of appetite, sleeplessness, anergia, and loss of interest in, and enjoyment of, the normal pursuits of life. There is a wide spectrum of depressive symptoms as well as types of available therapies.

Because of the many physical illnesses and social and economic problems of the elderly, individual health care providers often conclude that depression is a normal consequence

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