BARRIERS TO DIAGNOSIS AND TREATMENT OF DEPRESSION IN ELDERLY PATIENTS

Several barriers to proper diagnosis and treatment of depression in el derly patients have been identified. These include misattribution of s ymptoms to ''normal'' aging incorrect diagnosis, and social stigma. On e plausible explanation for missed diagnoses is that the criteria used to identify major depression were developed in younger individuals an d are less valid in older patients. This hypothesis has proven to be d ifficult to test because methods for studying the validity of diagnosi s have advanced little since the time of Kraepelin 100 years ago. A re newed focus on the issue of validity could benefit older depressed ind ividuals by improving methods for identifying depression and measuring response to treatment. Rather than labeling depression in late life a s more likely to present ''atypically,'' it may be more important to a ppreciate that the phenomenology of depressive disorder can vary acros s the life span.