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Chapter 15. Mood Disorders

Dan G. Blazer, M.D., Ph.D.; David C. Steffens, M.D., M.H.Sc.; Harold G. Koenig, M.D., M.H.Sc.
DOI: 10.1176/appi.books.9781585623754.391921

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Questions regarding depression in old age are frequently posed: Do persons become more depressed as they grow older? Does depression become more difficult to treat with increased age? Is depression more difficult to identify in the older adult? The answers to these questions rest in part with the definition of late-life depression. Depression in late life is not a unitary construct. Depending on how depression is defined, the answers to questions regarding late-life depression vary.

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Sample questions:
1.
You diagnose major depression in a physically healthy 76-year-old woman and recommend to her antidepressant medication. She responds by saying, "What's the use? I've heard that antidepressants are not very effective in older people." You state that if seniors are treated with an adequate dose of an antidepressant for a sufficient period of time (at least 6–9 months) they may expect a recovery rate of approximately
2.
Factors associated with improved outcome in late-life depression include which of the following?
3.
Certain psychological factors may contribute to the onset of late-life depressive symptoms. All of the following factors have been reported by investigators to increase the likelihood or frequency of late-life depressive symptoms except
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