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Depression Before and After Age 65: A Re-examination

  • Laura Musetti (a1), Giulio Perugi (a1), Adalgisa Soriani (a1), Vedia M. Rossi (a1), Giovanni B. Cassano (a1) and Hagop S. Akiskal (a2)...


Systematic and detailed psychopathological examination of 400 consecutive primary major depressives failed to confirm common clinical stereotypes which ascribe greater somatisation, hypochondriasis, agitation, psychotic tendencies, and chronicity to old age. Those above 65 were more likely to suffer from single episodes of depression that were often precipitated, whereas subjects whose illness began earlier were more likely to express depression as part of a recurrent unipolar or bipolar disorder, with higher rates of affective temperamental pathology and familial affective illness. The acute clinical picture was relatively uniform in older and younger depressives and, taken together with the other findings, tends to favour a spectrum model of primary mood disorders.


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Akiskal, H. S. (1982) Factors associated with incomplete recovery in primary depressive illness. Journal of Clinical Psychiatry, 43, 266271.
Akiskal, H. S. (1983a) Diagnosis and classification of affective disorders: new insights from clinical and laboratory approaches. Psychiatric Developments, 2, 123160.
Akiskal, H. S. (1983b) The bipolar spectrum: new concepts in classification and diagnosis In Psychiatry Update: the American Psychiatric Association Annual Review, Vol. 2 (ed.) L. Grinspoon. Washington, DC: American Psychiatric Press.
Akiskal, H. S., Walker, P. W., Puzantian, V. R., et al (1983) Bipolar outcome in the course of depressive illness: phenomenologic, familial and pharmacological predictors. Journal of Affective Disorders, 5, 115128.
Akiskal, H. S. & Mallya, G. (1987) Criteria for the soft bipolar spectrum: treatment implications. Psychopharmacology Bulletin, 23, 6873.
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised). Washington, DC: American Psychiatric Press.
Andreasen, N. C., Endicott, J., Spitzer, R. L., et al (1977) The family history method using diagnostic criteria. Archives of General Psychiatry, 34, 12291235.
Angst, J. (1966) Zur atiologie und nosologie endogener depressiver psycosen. Monographien aus dem Gesamtgebiete der Neurologie und Psychiatrie, 112, 1118. Berlin: Springer Verlag.
Blazer, O. & Williams, C. D. (1980) Epidemiology of dysphoria and depression in an elderly population. American Journal of Psychiatry, 137, 439444.
Busse, E. W. & Blazer, D. G. (1980) Disorders related to biological functioning. Handbook of Geriatric Psychiatry. New York: Van Nostrand Reinhold.
Cassano, G. B., Musetti, L., Perugi, G., et al (1987) Major depression subcategories: their potentiality for clinical research. Diagnosis and treatment of depression In Diagnostic et Traitement de la Dépression (eds K. Biziére, S. Garattini & P. Simon). Montpellier: Sanofi Recherche.
Ciompi, L. (1969) Follow-up studies in the evolution of former neurotic and depressive states. Journal of Geriatric Psychiatry, 3, 90106.
Coryell, W., Endicott, J., Andreasen, N., et al (1985) Bipolar I, bipolar II, and nonbipolar major depression among the relatives of affectively ill probands. American Journal of Psychiatry, 142, 817823.
Depeu, R. A. & Monroe, S. M. D. (1978) The unipolar-bipolar distinction in the depressive disorders. Psychological Bulletin, 85, 10011009.
Derogatis, L. R., Lipman, R. S. & Rickels, S. K. (1973) The Hopkins Symptoms Checklist (HSCL): a measure of primary symptoms dimensions in psychological measurement In Modern Problems Pharmacopsychiatry (ed.) P. Pichot. Basel: Karger.
Finlayson, R. E. & Martin, L. M. (1982) Recognition and management of depression in the elderly. Mayo Clinic Proceedings, 57, 115120.
Glasser, M. & Rabins, P. (1984) Mania in the elderly. Age and Aging, 13, 210213.
Goldfarb, A. I. (1967) Masked depression in the old. American Journal of Psychotherapy, 21, 791803.
Goldstein, S. E. (1979) Depression in the elderly. Journal of American Geriatric Society, 27, 3842.
Gurland, B. (1976) The comparative frequency of depression in various adult age groups. Journal of Gerontology, 31, 283292.
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social Clinical Psychology, 6, 278296.
Hopkinson, G. E. & Ley, P. (1969) A genetic study of affective disorder. British Journal of Psychiatry, 115, 917922.
Jacoby, R. J., Levy, R., & Bird, J. M. (1981) Computed tomography and the outcome of affective disorders: a follow-up study of patients. British Journal of Psychiatry, 139, 288292.
Katon, W. (1982) Depression: somatic symptoms and medical disorders in primary care. Comprehensive Psychiatry, 23, 274287.
Kukull, W. A., Koepsell, T. D., Inui, T. S., et al (1986) Depression and physical illness among elderly general medical clinic patients. Journal of Affective Disorders, 10, 153162.
Mendlewicz, J. (1976) The age factor in depressive illness: some genetic considerations. Journal of Gerontology, 31, 300303.
Murphy, E. (1982) Social origins of depression in old age. British Journal of Psychiatry, 141, 135142.
Murphy, E. (1983) The prognosis of depression. British Journal of Psychiatry, 142, 111119.
Nielsen, A. C. & Williams, T. A. (1980) Depression in ambulatory medical patients: prevalence by self report questionnaire and recognition by nonpsychiatric physicians. Archives of General Psychiatry, 37, 9991004.
Pichot, P. & Pull, C. (1981) Is there an involutional melancholia? Comprehensive Psychiatry, 22, 210.
Placidi, G. F., Rampello, E. & Cassano, G. B. (1984) La depressione nell'età senile: aspetti clinici e terapeutici. Quaderni Italiani di Psichiatria, III, 336.
Post, F. (1987) Depression, alcoholism, and other functional syndromes In Psychogeriatrics - an International Handbook (ed.) M. Bergener. New York: Springer Publishing Company.
Roth, M. (1976) The psychiatric disorders of later life. Psychiatric Annals. 6, 57101.
Saltzman, C. & Shader, R. I. (1978) Depression in the elderly - I. Relationship between depression, psychologic defense mechanism and physical illness. Journal of American Geriatric Society, 26, 253260.
Schneider, K. (1958) Psychopathic Personalities (trans, by Hamilton, M. W.). London: Cassell.
Shamoian, C. A. (1985) Assessing depression in elderly patients. Hospital and Community Psychiatry, 36, 338339.
Shulman, K. & Post, F. (1980) Bipolar affective disorder in old age. British Journal of Psychiatry, 136, 2632.
Steuer, J., Bank, L., Olsen, E. J., et al (1980) Depression, physical health, and somatic complaints in the elderly: a study of the Zung Self-Rating Depression Scale. Journal of Gerontology, 35, 683688.
Widlöcher, D. (1983) Psychomotor retardation: clinical, theoretical, and psychometric aspects. Psychiatric Clinics of North America, 6, 2740.
Winokur, G., Morrison, J., Clancy, J., et al (1973) The Iowa 500: familial and clinical findings favor two kinds of depressive illness. Comprehensive Psychiatry, 14, 99107.
Winokur, G., Behan, D. & Schlesser, M. (1980) Clinical and biological aspects of depression in the elderly In Psychopathology in the Aged (eds J O. Cole & J. E. Barrett). New York: Raven Press.

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Depression Before and After Age 65: A Re-examination

  • Laura Musetti (a1), Giulio Perugi (a1), Adalgisa Soriani (a1), Vedia M. Rossi (a1), Giovanni B. Cassano (a1) and Hagop S. Akiskal (a2)...


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Depression Before and After Age 65: A Re-examination

  • Laura Musetti (a1), Giulio Perugi (a1), Adalgisa Soriani (a1), Vedia M. Rossi (a1), Giovanni B. Cassano (a1) and Hagop S. Akiskal (a2)...
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