PREVENTION OF DEPRESSION, RECURRENCES, AND COMPLICATIONS IN LATE-LIFE

As emphasized in the recent NIH Consensus Statement on the Diagnosis a nd Treatment of Depression in Late Life, depression in the elderly is a persistent or recurrent disorder that can result from psychosocial s tress or physiological effects of disease and can lead to excess disab ility, cognitive impairment, increased symptoms from medical illness, physiological effects, increased utilization of health care services, and increased rates of suicide and nonsuicide mortality. Primary preve ntion can target high-risk groups including those with specific medica l illnesses, disabling chronic diseases, widows/widowers, and spousal caregivers. Secondary prevention of recurrences of major depression is possible through maintenance treatment with antidepressant medication s. Secondary prevention of behavioral complications such as suicide an d alcoholism and of excess disability, morbidity, and utilization of g eneral health services in patients with psychiatric-medical comorbidit y can be facilitated by systematic approaches to case identification a nd treatment for depression in medical patients. (C) 1994 Academic Pre ss, Inc.