Skip to main content Accessibility help
×
Home
  • Print publication year: 2008
  • Online publication date: December 2009

Appendix: International commentaries

Summary

The editors summarized the contributions written by colleagues in different parts of the world (Chapter 6) to illustrate the similarities, and occasional differences, in the management of depression in older people described in all the contributions. This appendix allows the reader to read the individual contributions.

Australia

Assessment

This 82-year-old woman is chronically disabled by pain and breathlessness and appears to have become socially disengaged. She has several symptoms of depression, including persistent low mood, loss of energy (which sounds to be out of proportion to her medical state), early morning waking, loss of interest in previously enjoyed activities, and persistent feelings that life is not worth living. The vignette does not provide information about her appetite and weight, concentration, any psychomotor changes, guilt feelings or confidence levels, but even so it is clear that, provided the symptoms have been present for two weeks (and this seems highly likely), she meets both DSM-IV diagnostic criteria for a major depressive episode and ICD-10 criteria for a depressive episode.

Australian health-care system

Within the Australian health-care system, in which specialists are accessible only after referral from a general practitioner (GP), this woman would normally be managed by her GP who in all likelihood will already be engaged in the management of her troublesome osteoarthritis and chronic obstructive pulmonary disease (COPD). She might well attend a respiratory outpatient clinic or rheumatology clinic in a public hospital, or (less likely as fewer than one-third of the elderly have private health insurance) be seeing a private medical specialist with expertise in one or both of these two areas.

REFERENCES
Ames D. (2001) Depression and the elderly. In Depression: Social and Economic Timebomb, eds. Dawson, A. and Tylee, A.. London: BMJ Books, pp. 49–54.
Llewellyn-Jones, R., Baike, K., Smithers, H., Cohen, J., Snowdon, J. (1999) Multifaceted shared care intervention for late-life depression in residential care: randomized controlled trial. Br. Med. J. 319, 676–82.
LoGiudice D., Flynn E., Ames D. (2005) Services to people with dementia: a worldwide view – Australia. In Dementia, eds. Burns, A., O'Brien, J. and Ames, D.. London: Hodder Arnold, pp. 256–60.
REFERENCES
Kennedy, S. H., Lam, R. W. and the CANMAT Depression Working Group (2001) Clinical guidelines for the treatment of depressive disorders. Can. J. Psychiatry 46 (Suppl. 1), 1S–92S.
Canadian Coalition for Seniors' Mental Health (2006) National Guidelines for Seniors' Mental Health. The Assessment and Treatment of Depression. Available online at www.ccsmh.ca
REFERENCES
Chiu, H. F. K., Pang, A. H. T., Lam, L. C. W. (1996) Letter from Hong Kong. Int. J. Geriatr. Psychiatry 11, 711–13.
Chiu, H. F. K., Takahashi, Y, Suh, G. H. (2003) Elderly suicide prevention in East Asia. Int. J. Geriatr. Psychiatry 18, 973–6.
REFERENCES
Awata, S., Seki, T., Koizumi, Y., et al. (2005a) Factors associated with suicidal ideation in an elderly urban Japanese population: a community-based cross-sectional study. Psychiatr. Clin. Neurosci. 59, 327–36.
Awata, S., Seki, T., Koizumi, Y., et al. (2005b) Effects of a comprehensive community intervention model to reduce late-life depression and suicidal ideation in an urban residential district. Int. Psychogeriatrics 17 (Suppl. 2), 381–2.
Awata, S., Bech, P., Yoshida, S., et al. (2007a). Reliability and validity of the Japanese version of the WHO-Five Well-Being Index in the context of detecting depression in diabetic patients. Psychiatr. Clin. Neurosci. 61, 112–19.
Awata, S., Bech, P., Koizumi, Y., et al. (2007b). Validity and utility of the Japanese version of the WHO-Five Well-Being Index in the context of detecting suicidal ideation in elderly community residents. Int. Psychogeriatrics 19, 77–88.
Bech, P., Olsen, L. R., Kjoller, M., Rasmussen, N. K. (2003) Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five Well-Being Scale. Int. J. Methods Psychiatr. Res. 12, 85–91.
Bonsignore, M., Barkow, K., Jessen, F., Heun, R. (2001) Validity of the five-item WHO Well-Being Index (WHO-5) in an elderly population. Eur. Arch. Psychiatry Clin. Neurosci. 251 (Suppl. 2), II/27–II/31.
Conwell, Y., Duberstein, P. R., Caine, E. (2002) Risk factors for suicide in later life. Biol. Psychiatry 52, 193–204.
Hegerl, U., Althaus, D. (2003) From patient screening to management list in suicide risk: practical guidelines for dealing with depression. MMW Fortshritte der Medizin, 145: 24–27.
Henkel, V., Mergl, R., Kohnen, R., et al. (2003) Identifying depression in primary care: a comparison of different methods in a prospective cohort study. Br. Med. J. 326, 200–1.
Henkel, V., Mergl, R., Coynbe, J. C., et al. (2004) Screening for depression in primary care: will one or two items suffice?Eur. Arch. Psychiatry Clin. Neurosci. 254, 215–23.
Heun, R., Burkart, M., Maier, M., Bech, P. (1999) Internal and external validity of the WHO Well-Being Scale in the elderly general population. Acta Psychiatr. Scand. 99, 171–8.
Japan Medical Association (2004) The Manual for Suicide Prevention. Tokyo: Japan Medical Association.
O'Connell, H., Chin, A. V., Cunningham, C., Lawlor, B. (2005). Recent developments: suicide in older people. Br. Med. J. 329, 895–9.
Quan, H., Arboleda-Florez, J., Fick, G. H., et al. (2002) Association between physical illness and suicide among the elderly. Soc. Psychiatry Psychiatr. Epidemiol. 37, 190–7.
World Health Organization (2005) WHO-Five Well-Being Index. Geneva: WHO. Available online at www.who-5.org/
REFERENCES
Beekman, A. T. F., Deeg, D., Braam, A. W., Smit, J. H., Tilburg, W. (1997) Consequences of major and minor depression in later life: a study of disability, well-being and service utilization. Psychol. Med. 27, 1397–409.
Netherlands Institute of Mental Health and Addiction (2006) Multidisciplinaire Richtlijn Depressie [Multidisciplinary Guidelines for the Treatment of Depression]:, Addendum for Late-Life Depression. Utrecht: Trimbos Institut.
Marwijk, H., Grundmeijer, H., Bijl, D., et al. (2003) NHG-Standaard Depressieve Stoornis (Depressie), Eerste herziening. [Dutch College of General Practitioners Guideline Depression, first revision]Huisarts Wet. 46, 614–33.
Schaik, D. J. F., Marwijk, H., Ader, H., et al. (2006) Interpersonal psychotherapy for elderly patients in primary care. Am. J. Geriatr. Psychiatry 14, 777–86.
REFERENCES
Government of Romania (2002) Mental Health Law. Monitorul oficial al Romaniei XIV(589), August 2002.
Health Department (2003) Standards for residence care. Monitorul oficial al Romaniei, XV(255), April 2003.
REFERENCES
Blazer, D. (1998) Emotional problems associated with physical illness. In Emotional Problems in Later Life: Intervention Strategies for Professional Caregivers, 2nd edn. New York: Springer, pp. 181–99.
Cerecedo-Pérez M. J., Ruiz-Gómes M. (2005) Abordaje de los problemas de salud mental: ‘Doctora estoy deprimida.’ – Abordaje de las alteraciones del estado de ánimo por el médico de familia [The management of mental health problems: ‘Doctor I am depressed.’ – The management of mood disorders by the family doctor]. Formación Acreditada On-Line: El Médico Interactivo. Available online at www.elmedicointeractivo.com/formacion_acre2005/temas/tema5-6/abordaje.htm.
Martin, Fernandez-San M. I., Andrade, C., Molina, J., et al. (2002) Validation of the Spanish version of the Geriatric Depression Scale (GDS) in primary care. Int. J. Geriatr. Psychiatry 17, 279–87.
Mateos R., Gómez-Campos R. (2001) Diagnóstico y tratamiento de la ansiedad en el anciano, Serie Grandes Síndromes Geriatricos. Protocolos de la Sociedad Española de Geriatría y Gerontología [Diagnosis and treatment of anxiety in the elderly, Major Geriatric Disorders Series. Protocols of the Spanish Society of Geriatrics and Gerontology]. Available online at www.saludaliamedica.com/Med/protocolos/segg/SEGG_ansiedad/protocolo.htm.
Perez-Franco, B., Turabian-Fernandez, J. L. (2006) Is the orthodox approach to depression in primary care valid?. Aten. Primaria 37, 37–9.
Peveler, R., Carson, A., Rodin, G. (2002) Depression in medical patients. Br. Med. J. 325, 149–52.
Tellez-Lapeira, J. M., Cerecedo-Perez, M. J., Pascual-Pascual, P., Buitrago-Ramirez, F., Buitrago-Ramirez, F. (2005) Mental health on the threshold of the XXIst century: Primary care in the forefront – Are we up to the challenge?Aten. Primaria 35, 61–3.
Tizón, J. L. (1996) Componentes Psicológicos de la Práctica Médica: Una Perspectiva desde la Atención Primaria [Psychological Components of Medical Practice from the Primary Care Perspective], 4th edn. Barcelona: Doyma.
Korff, M., Glasgow, R. E., Sharpe, M. (2002) Organizing care for chronic illness. Br. Med. J. 325, 92–4.
REFERENCES
National Committee for Quality Assurance HEDIS (Health Plan Employer Data and Information Set). Available online at http: //web.ncqa.org
Unützer, J., Katon, W., Callahan, C., et al. (2002) Collaborative care management of late-life depression in the primary care setting. J. Am. Med. Assoc. 288, 2836–45.