[Presenile and senile affective disorders].
The significance of endogenous factors becomes smaller and that of psychogenic or exogenous factors grows larger in affective disorders after the middle age. Psychogenic or exogenous factors include occupational factors, such as, retirement, familial factors, such as death of one's spouse, and independence of one's children, and somatic factors, such as ageing and somatic diseases. Atypical symptoms are more frequently seen than in the younger age. Somatic symptoms, hypochondriasis, agitation and paranoid are seen more frequently than in the younger age. On the other hand psychomotor inhibition is not so serious after the middle age. Masked depression, depressive pseudo-dementia and drug-induced depressive state are seen more often, and they should be distinguished from somatic diseases and dementia. On manic state typical manic symptoms such as flight of ideas and manic excitement, are not seen so often as in the younger age. Adequate rest, medication and psychotherapy are necessary for the therapy of affective disorders. Considering pharmacokinetics in the elderly, anti-depressants with less side effects should be chosen and they should be started from one-third of the regular dosage at most.
Kasahara
H
H
Department of Psychiatry, Jikei University, School of Medicine, Kashiwa Hospital.
Nakano
H
H
D017668:Age of Onset; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D019964:Mood Disorders / Q000523:psychology / Q000628:therapy; D012931:Social Environment
D000928:Antidepressive Agents