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Diagnosis and Treatment of Depression in Late Life

Arnold J. Friedhoff, MD; James Ballenger, RD; Alan S. Bellack, PhD; William T. Carpenter Jr, MD; Helena Chang Chui, MD; Rose Dobrof, DSW; Joyce J. Fitzpatrick, PhD, RN, FRAN; Rudolph Freeman Jr, MD; George R. Heninger, MD; Philip W. Lavori, PhD; Kathleen Ries Merikangas, PhD; Raymond Raschko, MSW; Martha Storandt, PhD; Mark E. Williams, MD; Charles F. Reynolds III, MD; Dan G. Blazer II, MD, PhD; Eric D. Caine, MD; Burton V. Reifler, MD, MPH; Elaine Murphy, MD; George S. Alexopoulos, MD; Andrew F. Leuchter, MD; Linda K. George, PhD; Paul T. Costa Jr, PhD; A. John Rush, MD; Carl Salzman, MD; James M. Perel, PhD; Harold A. Sackeim, PhD; Linda Teri, PhD; George Niederehe, PhD; Ellen Frank, PhD; Sidney Klawansky, MD, PhD; Joel B. Greenhouse, MPH, PhD; Lon S. Schneider, MD; Gary L. Gottlieb, MD, MBA; Yeates Conwell, MD; Sidney Zisook, MD; Ira R. Katz, MD, PhD; Barry D. Lebowitz, PhD; Marsha Corbett; Jerry M. Elliott; John H. Ferguson, MD; James L. Fosard, PhD; William H. Hall; Jane L. Pearson, PhD
JAMA. 1992;268(8):1018-1024. doi:10.1001/jama.1992.03490080092032.
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DEPRESSION in the aging and the aged is a major public health problem. It causes suffering to many who go undiagnosed, and it burdens families and institutions providing care for the elderly by disabling those who might otherwise be able-bodied. What makes depression in the elderly so insidious is that neither the victim nor the health care provider may recognize its symptoms in the context of the multiple physical problems of many elderly people. Depressed mood, the typical signature of depression, may be less prominent than other depressive symptoms such as loss of appetite, sleeplessness, anergia, and loss of interest in, and enjoyment of, the normal pursuits of life. There is a wide spectrum of depressive symptoms as well as types of available therapies.

Because of the many physical illnesses and social and economic problems of the elderly, individual health care providers often conclude that depression is a normal consequence


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