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Appendix: International commentaries

Published online by Cambridge University Press:  18 December 2009

Carolyn A. Chew-Graham
University of Manchester
Robert Baldwin
Manchester Mental Health and Social Care NHS Trust
Alistair Burns
University of Manchester
David Ames
Professor of Psychiatry of Old Age, University of Melbourne
Eleanor Flynn
Senior Lecturer in Medical Education, University of Melbourne
Maria Alekxandrova
Associate Professor of Psychiatry, Medical University Pleven
Kaloyan Stoychev
Consultant Psychiatrist, University Hospital Pleven
Kenneth Shulman
Professor of Geriatric Psychiatry, University of Toronto
Ross Upshur
Professor of Primary Care, University of Toronto
Kirsten Abelskov
Old-Age Psychiatrist, Aarhus University Hospital
Kaj Sparle Christensen
General Practitioner, Institut for Almen Medicin, University of Aarhus
Philippe H. Robert
Professor of Psychiatry
Michel Benoit
Psychiatrist Centre Mémoire de Ressources et de Recherche, Nice
Florence Cabane
General Practitioner Nice
Geneviève Ruault
Geriatrician Nice
Helen F. K. Chiu
Professor of Psychiatry, The Chinese University of Hong Kong
D. K. T. Li
Family Physician, Past President Hong Kong College of Family Physicians
Syuichi Awata
Psychiatrist and Director Division of Neuropsychiatry and Center for Dementia, Sendai City Hospital
Akira Honma
Psychiatrist, Tokyo Metropolitan Institute of Gerontology
Els Licht-Strunk
General Practitioner, VU University Medical Centre, Amsterdam
Marijke Bremmer
Consultant Psychiatrist, VU University Medical Centre, Amsterdam
Knut Engedal
Professor of Old-Age Psychiatry, Ullevaal University Hospital, Oslo
Harald Sanaker
Specialist in Family Medicine, Kongsvegen Legesenter, Brummunddal
Nicoleta Tătaru
Senior Consultant Psychiatrist, Forensic Hospital Ştei, Bihor
Monica Bălan
Primary Care Physician Oradea
Alexandru Dicker
Senior Consultant in Internal Medicine Psychiatric Hospital, Nucet, Bihor
Raimundo Mateos
Professor of Psychiatry, University of Santiago de Compostela
Jose Antonio Ferreiro Guri
Specialist in Family and Community, Medicine University of Santiago de Compostela
Tom Campbell
Professor of Family Medicine, University of Rochester, NY
Jeffrey M. Lyness
Professor of Psychiatry, University of Rochester, NY
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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.



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.

Publisher: Cambridge University Press
Print publication year: 2008

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