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Refractory depression in late life: a review of treatment options

Published online by Cambridge University Press:  17 November 2008

RC Baldwin*
Manchester Royal Infirmary, Manchester, UK
Central Manchester Healthcare Trust, York House, Manchester Royal Infirmary, Oxford Road, Manchester M13 9BX, UK.


There seems reasonable, if depressing, agreement from studies of mixed aged subjects and elderly subjects in psychiatric settings that nonresponse or poor response to a course of an antidepressant occurs in at least one-third of depressed patients. The figure may be higher in elderly patients in general and those with poor physical health. The human cost of chronic depression is highlighted in the Medical Outcomes Study. The level of functional impairment and intereference with quality of life associated with depression was comparable with or worse than that of eight major chronic medical conditions, including diabetes, arthritis and severe coronary artery disease. The final tragedy for unremitting depression may of course be suicide.

Psychiatry of old age
Copyright © Cambridge University Press 1996

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