[Depression in the elderly. Clinical aspects].
DIFFICULT DIAGNOSIS: Depression in the elderly can take on many often misleading aspects. Sadness may be considered legitimate or "normal" for an elderly person. Depression may masquerade as an organic disorder where somatic complaints, pain and anxiety predominate. All these different clinical forms may mislead the clinician. THE MASK OF HYPOCHONDRIA: A tendency to hypochondria, found in more than one-half of all depressed elderly subjects, may be reinforced by bouts of complementary examinations. The patient is convinced of having an unrecognized organic disease. The mask of hypochondria must be considered with special care because it is a major risk factor for attempted and successful suicide. THE MASK OF DELUSIONS: Elderly patients often develop a state of melancolia-like depression with delusions. Delusions may be congruent with the predominant depressed mood, for example a guilt feeling for an act never committed, or inversely, non-congruent with the thymic state (persecution, negation delusin), for example Cotard syndrome where the patient is persuaded that his/her organs are malfunctioning or have disappeared. Despite these impressive mood disorders that often incite prescription of a neuroleptic, these elderly patients respond favorably to antidepressor treatment.
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Secteur 84.G.02, Centre Hospitalier de Montfavet, 2, avenue de la Pinède, BP 92, F 84128 Montfavet.
D000368:Aged; D000375:Aging / Q000523:psychology; D003702:Delusions / Q000209:etiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005852:Geriatric Psychiatry; D006801:Humans; D006998:Hypochondriasis / Q000175:diagnosis* / Q000523:psychology; D019964:Mood Disorders / Q000175:diagnosis