[Depression among nursing home residents--diagnosis and treatment].
BACKGROUND
Depression affecting the elderly can express itself atypically, thus making diagnosis difficult; treatment can also present specific challenges in this age group. Proper diagnosis and adequate treatment measures give good therapeutic results among the elderly. On the other hand: untreated depression in this age group can have dramatic consequences such as chronic depression.


METHODS
Recent literature has been evaluated concerning diagnostic and treatment methods for the elderly, as have studies of the prevalence of depression among patients admitted to Norwegian nursing homes. A questionnaire survey was carried out on the use of medical treatment in four nursing homes.


CONCLUSIONS
Prevalence studies reveal that depression increases with age generally and especially among nursing home residents. This overrepresentation can be explained by various factors associated with institutionalisation and the aging process as a whole. The survey indicated that there exists a potential for improving the diagnosis of depression in nursing homes. The background for this could be inadequate routines or diagnostic instruments, insufficient time for interaction between patient and physicians/other caregivers, as well as insufficient knowledge among professionals. Improvements could come from giving more attention to atypical depression, designing diagnostic routines, using standardised instruments more systematically, and strengthening the general awareness and knowledge of depression. As a general rule, non-pharmacologic treatment options for depression should always be available. Antidepressants can yield good results provided that a proper diagnosis has been made and that the dosage is adjusted according to age. Treatment should be evaluated regularly. Electroconvulsive treatment is effective for many elderly.
Ruset
Arne
A
Helse Nordmøre og Romsdal HF, Distriktspsykiatrisk avdeling, Alderspsykiatrisk seksjon Molde sjukehus, 6450 Hjelset. arne.ruset@helsenr.no
D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D004363:Drug Utilization; D004565:Electroconvulsive Therapy; D005852:Geriatric Psychiatry; D006801:Humans; D009664:Norway / Q000453:epidemiology; D009735:Nursing Homes; D015995:Prevalence; D011613:Psychotherapy; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents