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Psychological techniques• Effective though few trials• Need to adapt techniques– loneliness– loss– facing death• Cognitive therapy– elderly DO change their negative cognitions– measurable and sustained antidepressant effect– effective in group setting with nurse therapists• Behaviour therapy– similar magnitude of effect to cognitive therapy
Depression and interpersonaltherapyInterpersonal psychotherapy (IPT),which is widely used in the UnitedStates and increasingly so inEurope has been shown to beeffective on its own and withnortryptylinein acute, continuationand maintenance treatment ofdepression in older peopleRey nol ds et al 199 7, 1999)
Page 1 and 2: Depression in Old AgeCornelius Kato
Page 3 and 4: Overview• Epidemiology• Details
Page 5 and 6: StudyDiagnosticcriterianAge% ‘Maj
Page 7 and 8: Prevalence of affectivedisorders ac
Page 9 and 10: Morbidityn %Anxiety disorderDementi
Page 11 and 12: Psychotropic drug usageTotalpopulat
Page 13 and 14: Why is depression not treatedin old
Page 15 and 16: The Geriatric Depression Scale (GDS
Page 17 and 18: GDS-4Are you basically satisfied wi
Page 19 and 20: Treatment options• Need for holis
Page 21 and 22: Newer antidepressants• SSRIs- flu
Page 23 and 24: NUMBER NEEDED TO TREAT• Number of
Page 25 and 26: Authors Drug N Measure NNT 95% CIac
Page 27 and 28: Authors Drugs N (Drug1)Nair et al95
Page 29 and 30: MeanHAM-Dtotal scoreElderly depress
Page 31: • Effective• Safe- Mulsant et a
Page 35 and 36: Citalopram vs placebo in comorbidde
Page 37 and 38: 01234Response of neuropsychiatric a
Page 39 and 40: Risk of depression inphysically ill
Page 41 and 42: Mortality following hip fracture%Ps
Page 43 and 44: Lofepramine vs Placebo4 week trialL
Page 45 and 46: Fluoxetine vs Placebon=8262 complet
Page 47 and 48: Lithium• Effective in prophylaxis
Page 49 and 50: METHYLPHENIDATE16 medically ill pat
Page 51 and 52: ECT vs Paroxetine• RCT• n=39•
Page 53 and 54: Prognostic community studies ofdepr
Page 55 and 56: Cattell and Jolley, 1995• 100 con
Page 57 and 58: Logistic regressionp
Page 59 and 60: Prevention of depressionrecurrence
Page 61 and 62: Antidepressant +PsychotherapyNT+ NT

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