Öldrun - 01.05.2004, Page 11

11ÖLDRUN – 22. árg. 1. tbl. 2004 www.oldrun.net
Annars stigs forvarnir miða að því að koma í veg
fyrir að fólk fái endurtekin þunglyndisköst og miða að
því að fylgjast vel með þeim sem fá sjúkdóminn og veita
þeim viðeigandi meðferð m. a. með því að halda áfram
að gefa þeim þunglyndislyf í að minnsta kosti eitt ár eftir
að þeim er batnað.
Þriðja stigs forvarnir miða að því að draga úr
afleiðingum þunglyndis. Þær beinast m. a. að þeim hópi
sjúklinga sem fá langvinnt þunglyndi sem svarar illa
meðferð.
Lokaorð
Þunglyndi er algengasti geðsjúkdómurinn sem
hrjáir eldra fólk. Sjúkdómurinn getur valdið alvarlegri
fötlun og er tengdur aukinni dánartíðni. Það er því mjög
mikilvægt að stjórnvöld sjái til þess að almenningur eigi
greiðan aðgang að aðilum sem
geta greint sjúkdóminn, með-
höndlað hann og fylgst með
bata.
Heimildir
1. WHO. ICD-10: Classification of mental
and behavioral disorders: Diagnostic
riteria for reaserch: Geneva Switzer-
land: World Health Organization
1993:77-90.
2. Lebowitz BD, Pearson JL et al.
Diagnosis and treatment of depression
in late life. Consensus statement
update. JAMA 1997;278:1186-1190.
3. Pálsson S, Johansson B et al. A popula-
tion study on the influence of depres-
sion on neuropsychological functioning
in 85-years-olds. Acta Psychiatr Scand
2000;101:185-193.
4. Mehta KM, Simonsick EM et al.
Prevalence and correlates of anxiety
symptoms in well-functioning older
adults: Findings from the health aging
and body composition study. J Am
Geriatr Soc 2003;51:499-504.
5. Huang BY, Commoni-Huntley J et al.
Impact of depressive symptoms on hos-
pitalisation risk in community-dwelling
older persons. J Am Geriatr Soc
2000;48:1279-1284.
6. Brenda W, Pennix BW et al. Changes in
depression and physical decline in
older adults: a longitudinal perspective.
J Affect Dis 2000;61:1-12.
7. Copeland JRM, Beekman ATE et al.
Depression in Europe: geographical
distribution among older people. Br J
Psychiatr 1999;174:312-321.
8. World Psychiatric Association WPA
International Committee for Pre-
vention and Treatment of Depression.
Depressive disorders in older persons
1999.
http://www.wpanet.org/
sectorial/edu4.html
9. Cole MG, Dendukuri N. Risk factors for
depression among elderly community
subjects: a systematic review and meta-
analysis. Am J Psychiatr 2003;160:1147-
1156
10. Katona C, Livingston G. Impact of
screening of old people with physical
illness for depression? Lancet 2000;
356:91-2.
11. Brink TL, Yesavage JA, Lum O,
Heersema P, Adey MB, Rose TL:
Screening tests for geriatric depres-
sion. Clin Gerontologist 1982;1:37-44.
12. Valdimarsdóttir M, Jónsson J E et al. Þunglyndismat fyrir aldraða - íslen-
sk gerð. Geriatric Depression Scale (GDS). Læknablaðið 2000; 86:344-
348.
13. Keller MB, Boland RJ. Implications of failing to achieve successful long-
term maintenance treatment of recurrent unipolar depression. Biol
Psychiatr 1998;44:348-60.
14. Wilson K, Mottram P et al. Antidepressants versus placebo for the
depressed elderly. Cochrane Database of Systematic Reviews 3, 2003
(rafræn heimild).
15. Williams JW, Barrett J et al. Treatment of dysthymia and minor depres-
sion in primary care: a randomised controlled trial in older adults.
JAMA 2000;284:1519-26
16. Tew JD, Mulsant BH et al. Acute efficacy of ECT in the treatment of
major depression in the old-old. Am J Psychiatr 1999;156:1865-70.
17. Anderson DN. Treating depression in old age: the reasons to be posi-
tive. Age and Ageing 2001;30:13-17.
18. Pinquart M, Sorensen D. How effective are psychotherapeutic and
other psychosocial interventions with older adults? A meta-analysis. J
Mental Health Aging 2001;7:207-43.
19. Tuma TA. Outcome of hospital-treated depression at 4.5 years. An eld-
erly and a younger adult cohort compared. Br J Psychiatr 2000; 176:224-
8.
20. O´Brien JT, Ames D. Severe deep white matter lesions and outcome in
elderly patients with major depressive disorder: a follow-up study. BMJ
1998;317:982.