Trầm cảm đơn cực khởi phát muộn: Một bài tổng quan toàn diện

Annals of General Hospital Psychiatry - Tập 2 - Trang 1-14 - 2003
Konstantinos N Fountoulakis1, Ruth O'Hara2, Apostolos Iacovides1, Christopher P Camilleri2, Stergios Kaprinis1, George Kaprinis1, Jerome Yesavage2
13rd Department of Psychiatry, Aristotle University of Thessaloniki, Greece
2Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford California, U.S.A

Tóm tắt

Dân số người cao tuổi đang gia tăng trên toàn thế giới và số lượng bệnh nhân tâm thần cao tuổi cũng tăng theo, điều này thể hiện một số đặc điểm cụ thể và độc đáo. Mục tiêu của bài viết này là cung cấp một cái nhìn tổng quát về văn liệu quốc tế về trầm cảm đơn cực khởi phát ở tuổi già. Các tác giả đã xem xét một số trang và sách liên quan đến chủ đề nhưng không tìm kiếm toàn bộ tài liệu do quy mô quá lớn. Họ đã chọn xem xét những tài liệu được coi là quan trọng nhất. Tỷ lệ trầm cảm nặng ước tính là 2% trong dân số chung trên 65 tuổi. Hình ảnh lâm sàng của trầm cảm ở người cao tuổi khác biệt ở nhiều khía cạnh so với trầm cảm ở bệnh nhân trẻ hơn. Vẫn chưa rõ liệu nó có khác nhau giữa các nền văn hóa và các bối cảnh kinh tế - xã hội khác nhau hay không. Dữ liệu sinh học cho thấy nó liên quan đến mức độ nghiêm trọng tăng của bệnh lý mạch máu dưới vỏ não và suy giảm khả năng nhận thức lớn hơn. Nhiều tác giả cho rằng sự tồn tại của rối loạn cơ thể có liên quan đến sự hiện diện của trầm cảm trong giai đoạn cuối đời, thậm chí cấu thành một yếu tố tiên lượng tiêu cực cho kết quả của trầm cảm. Hầu hết các nghiên cứu hỗ trợ quan điểm rằng trầm cảm ở người cao tuổi có tiên lượng xấu hơn trầm cảm ở bệnh nhân trẻ hơn. Can thiệp điều trị bao gồm liệu pháp dược lý, chủ yếu là thuốc chống trầm cảm, được đánh giá là có giá trị, và liệu pháp tâm lý, chưa được xác thực một cách đồng đều. Một số lượng đáng kể các câu hỏi liên quan đến đánh giá và điều trị trầm cảm ở người cao tuổi vẫn chưa có câu trả lời, dữ liệu thực nghiệm còn hạn chế và cần nghiên cứu thêm.

Từ khóa

#trầm cảm đơn cực khởi phát muộn #trầm cảm ở người cao tuổi #điều trị trầm cảm #bệnh nhân tâm thần cao tuổi #tiên lượng trầm cảm

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