Monday, 18 August 2003: 13:45-15:15
Ontario Room (Sheraton Hotel and Towers)

S013 Late-Life Mood Disorder: Significant Progress but Many Unanswered Questions

Mood disorders in late life are relatively neglected in research compared to the dementias. In this symposium we aim to show that there has been substantial progress in our understanding of depressive disorder over recent decades. Presentations will exemplify this by exploring new topics such as vascular depression and progress in treatments such as treatment resistant depression. Epidemiological data consistently show that depression affects about 15% of older people, making it the most common mental health problem of older people. Our conceptualisation of depression is hindered by rigid diagnostic criteria and it is becoming clear that the most common form of depression in primary care practice, 'minor' depression, is in fact not at all trivial but associated with substantial morbidity. Despite this good progress many questions remain. For example although there is good evidence of efficacy for antidepressants in older people, it is harder to demonstrate that there has been any advance in the prognosis of depression over recent decades. In fact depression in the community remains under-recognised (although good screening tools exist)and under-treated. Rather than new treatments for depression, most progress is likely with innovative ways of using existing treatments. For example, models of collaborative care, emphasising active case management and improving links between primary and specialist care are now showing benefit in older populations of depressed patients. Vascular depression may hint at treatments not usually thought of as psychiatric, such as attention to vascular risk factors and vaso-protective agents, but more research is needed.
Chairs:Robert Baldwin
Thea J Heeren
 S013-001 Vascular Depression: A New Subtype of Geriatric Major Depression?
David Steffens
 S013-002 If at First You Don’t Succeed…: Treatment-Resistant Depression in Late-Life
Alastair Flint
 S013-003 Depression and Excess Mortality in Community Living Elderly: Which Mechanisms May Be Involved, and What Cues Can Be Obtained from Epidemiological Research?
Robert Schoevers, Aartjan Beekman, Mirjam I. Geerlings, Dorly Deeg, Cees Jonker, Willem Van Tilburg

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