Depression in older patients with neurologic illness: Causes, recognition, management
Alan Carson, MBChB, MPhil, MD
Department of Clinical Neurosciences, Western General Hospital, Edinburgh, United Kingdom
Richard Margolin, MD
Department of Psychiatry, Keck USC School of Medicine, Los Angeles, CA
Correspondence: Alan Carson, MBChB, MPhil, MD, MRCPsych, Department of Clinical Neurosciences, Western General Hospital, Edinburgh, United Kingdom; Alan.Carson@lpct.scot.nhs.uk
Dr. Carson has received speaker fees from the Janssen and Wyeth corporations.
Dr. Margolin is on the speakers’ bureaus of the Forest, Pfizer, and GlaxoSmithKline corporations.
Depression is common in the elderly, particularly in older persons with neurologic illness. Its etiology in this population is incompletely understood and likely to be multifactorial. Identifying depression in elderly patients with neurologic illness can be a challenge, as many of its features resemble symptoms of the underlying neurologic disease or of the aging process itself. Nevertheless, recognition and effective management of depression in this population is vital, since depression is a major source of excess morbidity and since treatment often results in improved quality of life for patients and their caregivers. Assessing for suidicality is a key diagnostic consideration in this population. Antidepressant medications, psychotherapy, and electroconvulsive therapy all can be effective in treating depression in elderly neurologic patients.
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