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CNS Drugs
Erschienen in: CNS Drugs 8/2007

01.08.2007 | Therapy in Practice

Depression in Nursing Homes

Ensuring Adequate Treatment

verfasst von: Dr Robert H. Llewellyn-Jones, John Snowdon

Erschienen in: CNS Drugs | Ausgabe 8/2007

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Abstract

Studies have shown a high prevalence of depressive disorders among nursing home residents around the world. Various losses in old age may precipitate depression, and physical illness and disability are major factors that contribute to the development and persistence of depressive disorders. Demoralisation (existential distress) is common. Recognition of what a nursing home resident has lost is often a key to developing plans for management. The prognosis for recovery from depression is worse for patients who face an ongoing distressing situation or physical condition. For ongoing loss-related distress, including sadness about loss of health, it is important for patients to ventilate feelings, and to either re-acquire what is lost or to grieve and then adapt to the new situation.
For major depression with melancholia, psychotic depression and bipolar disorders, biological treatments are of prime importance. Non-melancholic major depression is best treated with a combination of antidepressants and psychosocial therapies, the latter being particularly indicated when the depression has been precipitated by stressful and depressing events or situations. Psychosocial and environmental interventions are important in all types of depression and may prove more effective than the use of antidepressants for milder disorders.
There has been a welcome increase in the recognition of depression in nursing homes and in the prescription of newer antidepressants, but the published evidence to date does not allow definitive recommendations regarding which antidepressants to use in this setting. Outcome research is needed to assess antidepressant efficacy and to better plan multifaceted treatment strategies for depressions of varying types and aetiologies among nursing home residents.
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Metadaten
Titel
Depression in Nursing Homes
Ensuring Adequate Treatment
verfasst von
Dr Robert H. Llewellyn-Jones
John Snowdon
Publikationsdatum
01.08.2007
Verlag
Springer International Publishing
Erschienen in
CNS Drugs / Ausgabe 8/2007
Print ISSN: 1172-7047
Elektronische ISSN: 1179-1934
DOI
https://doi.org/10.2165/00023210-200721080-00002

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