Psychologie & NeuroPsychiatrie du vieillissement


Dépression du sujet âgé : perspectives Volume 2, supplement 1, Supplément, septembre 2004

Pôle universitaire de psychiatrie du sujet âgé, Centre Hospitalier Esquirol, Limoges jean‐pierre.clement@chello.fr

Extensive research has been achieved on the old age depression during the last decades. Specific clinical features and management have been reported. Indirect clinical and behavioural indicators, and even biological ones should be considered for the detection of depression. Cognitive assessment must be promoted in standard practice to differentiate depression from incipient dementia, but also in depression occuring in long stay care, vascular depression and in the depression‐executive dysfunction syndrome. Distinction between recurrent depressive episode and late‐onset depression has to be clarified. Therapeutic strategies have to be reconsidered in duration, according to the trend toward chronicity of late life depression. They remain based on the use of pluri‐aminergic antidepressants. Depressive disorder in the elderly is associated with hippocampus dysfunction, but other biological variables should be taken into account according to a dynamic stress‐vulnerability model.