The difficult elderly patient: curable hostile depression or personality disorder?
The aim of this article is to suggest that hostile behavior in elderly patients is often caused by a reversible mood disorder rather than by a personality disorder or dementia, even if these two last diagnoses are already well established. Sedatives, often prescribed for hostile behavior, can induce confusion, falls, and bedridden states, and can actually increase the rate of mortality. The mood disorder can be a hostile agitated depression or a mixed affective state. The hypothesis of a mood disorder calls for an antidepressant trial, possibly combined with a mood stabilizer.
Monfort
J C
JC
Service de psychiatrie, Hôpital Albert Chenevier, Créteil, France.
D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D015577:Geriatric Assessment; D006791:Hostility; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D010554:Personality Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D010817:Physician-Patient Relations; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012803:Sick Role
D000928:Antidepressive Agents