Diagnosis and Treatment of Depression in Late Life

Lon S. Schneider, M.D., is Associate Professor of Psychiatry and Neurology at University of Southern California School of Medicine in Los Angeles, California, and Senior Scientific Advisor at the National Institute of Mental Health in Rockville, Maryland. Charles F. Reynolds III, M.D., is Professor of Psychiatry and Neurology at Western Psychiatric Institute and Clinic, University of Pittsburgh, in Pittsburgh, Pennsylvania. Barry D. Lebowitz, Ph.D., is Chief, Mental Disorders of Aging Research Branch, Division of Clinical Research at National Institute of Mental Health in Rockville, Maryland. Arnold Friedhoff, M.D., is Professor of Psychiatry and Director of Millhauser Laboratories at the New York University School of Medicine in New York, New York.

Overview: Diagnosis and treatment of depression in late life. Epidemiology of late-life depression. Phenomenology, Clinical Heterogeneity, and Course. Clinical and etiological heterogeneity of mood disorders in elderly patients. Depression: diagnosis and comorbidity. The range of quality of life: relevance to the treatment of depression in elderly patients. The course and outcome of depression in late life. Biological and Psychosocial Factors. Biological correlates of late-life depression. Brain structural and functional correlates of late-life depression. Social factors and depression in late life. Depression as an enduring disposition. Treatment. Overview of treatment options in depressed elderly patients. Pharmacological treatment of depression in elderly patients. Geropharmacokinetics of therapeutics, toxic effects, and compliance. Use of electroconvulsive therapy in late-life depression. Cognitive-behavior therapy with depressed older adults. Psychosocial therapies with depressed older adults. Long-term prevention of recurrences in elderly patients. Meta-Analysis of Treatment in Late-Life Depression. Meta-analysis on the diagnosis and treatment of depression in late life. Meta-analysis review from a psychiatric statistical perspective. Meta-analysis review from a clinician's perspective. Special Issues. Barriers to care of older adults with depression. Suicide in elderly patients. Diagnosis and treatment considerations in depression associated with late-life bereavement. Depression in elderly patients in residential care settings. Treatment of depression in elderly patients: guidelines for primary care. Consensus Statement. Consensus Development Conference statement: diagnosis and treatment of depression in late life.