& | ' | No. 91-10 a WL 13 1993 oe Cae JON MOSIDIICIONIS NOV 26 1991 Treatment THU L\BRA ¢ HEAL! AUG g4 1093 of Aa a <.«Depression in Late-Life .. National Library January 1980 of Medicine | | through | September 1991 886 Citations U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service * National Institutes of Health ''''CBM 91-10 Diagnosis and Treatment of Depression in Late-Life January 1980 through September 1991 886 Citations Prepared by Martha H. Glock, M.L.S., National Library of Medicine Lon S. Schneider, M.D., National Institute of Mental Health and the University of Southern California U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutes of Health National Library of Medicine Reference Section 8600 Rockville Pike Bethesda, Maryland 20894 For sale by the U.S. Government Printing Office Superintendent of Documents, Mail Stop: SSOP, Washington, DC 20402-9328 ''SERIES NOTE Current Bibliographies in Medicine (CBM) is a continuation in part of the National Library of Medicine’s Literature Search Series, which ceased in 1987 with No. 87-15. In 1989 it also subsumed the Specialized Bibliography Series. Each bibliography in the new series covers a distinct subject area of biomedicine and is intended to fulfill a current awareness function. Citations are usually derived from searching a variety of online databases. NLM databases utilized include MEDLINE®, AVLINE®, BIOETHICSLINE?®, CANCERLIT®, CATLINE®, HEALTH, POPLINE™ and TOXLINE®. The only criterion for the inclusion of a particular published work is its relevance to the topic being presented; the format, ownership, or location of the material is not considered. Comments and suggestions on this series may be addressed to: Karen Patrias, Editor Current Bibliographies in Medicine Reference Section National Library of Medicine Bethesda, MD 20894 301/496-6097 Ordering Information: Current Bibliographies in Medicine is sold by the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. To order the entire CBM series for the calendar year 1991 (20 bibliographies), send $52.00 ($65.00 foreign) to the Superintendent of Documents citing GPO List ID: CBM91. For your convenience an order blank is given inside the back cover. Orders for individual bibliographies in the series ($3.00, $3.75 foreign) should be sent to the Superintendent of Documents citing the title, CBM number, and the GPO List ID given above. Use of funds for printing this periodical has been approved by the Director of the Office of Management and Budget through September 30, 1992. ii ''DIAGNOSIS AND TREATMENT OF DEPRESSION IN LATE-LIFE Depressive illness is a major public health problem among the elderly, whose proportion in the population is growing rapidly. With increasing longevity and the aging of the "baby boom" generation, the number of people 85 years and older will increase by 40 percent between 1984 and 2010 and will represent nearly 14 percent of the general population. Elderly depressed patients are overrepresented in hospitals, outpatient clinics, and institutions. The 1985 National Nursing Home Survey found that 25 percent of nursing home residents had major depression not including the 63 percent that were cognitively impaired. There is substantial evidence that the prognosis of depression in the elderly and treatment response may be poorer than in younger patients. Evidence for the efficacy of psychotherapy in older depressed adults has emerged only recently. Although pharmacotherapy is effective in older patients, it may not be as effective as it is in younger adults. Reasons for these differences remain to be explicated but include the possibilities that depression in late-life is different in phenomenology and natural history; that organicity or concurrent medical illness may mitigate the course of treatment response; that the physiological effects of aging per se may increase sensitivity to toxic effects or decrease sensitivity to therapeutic effects of medication; or that significant age-related pharmacokinetic and pharmacodynamic effects may impair response. The markedly increased rate of suicide in the elderly, depression among residents of long-term care facilities, and socioeconomic barriers to care are other special issues to be considered. Although significant progress has been made in understanding the diagnosis and treatment of depression in late life, important questions remain unresolved. This bibliography was prepared in support of the National Institutes of Health Consensus Development Conference on the Diagnosis and Treatment of Depression in Late-Life held in Bethesda, Maryland on November 4-6, 1991. The purpose of this Conference was to examine what is known of epidemiology, pathogenesis, pathophysiology, and treatment of major depression in the elderly as well as its prevention and management. The citations were selected to cover various aspects of depression in late-life including diagnosis, course, medical comorbidity, epidemiology, social factors, biological aspects, and treatments. In addition there are sections on special issues such as suicide, substance abuse, bereavement, and depression in nursing homes. This bibliography consists almost entirely of journal articles from January 1980 to September 1991. The 890 citations included were individually selected from a total of approximately 4000 generated. With few exceptions, books, chapters, proceedings and dissertations were not included. In general, reviews, editorials, case reports, and letters were also excluded, unless they represented a particular contribution to an area. There are four main categories: Diagnosis, Course, Epidemiological and Social Factors; Biological Aspects; Treatment; and Special Issues. Within each main category there are several subcategories. In areas that were considered in need of special attention, e.g., suicide, substance abuse, bereavement, and electroconvulsive therapy, nearly all the articles generated by the computerized search were included. A citation appears only once, under one category, even though it may be relevant to other categories. ili ''SEARCH STRATEGY A variety of online databases are usually searched in preparing bibliographies in the CBM series. To assist you in updating or otherwise manipulating the material in this search, the strategy used for the NLM’s MEDLINE database is given below. Please note that the search strategies presented here differ from individual demand searches in that they are generally broadly formulated and irrelevant citations edited out prior to printing. SS 1 = EXP AFFECTIVE DISORDERS OR EXPLODE AFFECTIVE DISORDERS, PSYCHOTIC SS 2 = DEPRESSION OR AFFECTIVE SYMPTOMS SS 3 = ALL BIPOLAR OR ALL UNIPOLAR OR ALL DYSTHYM: OR ALL MELANCHOL: SS 4= 1 OR 2 OR 3 SS 5 = 4 AND EXP AGED SS 6 = 4 AND AGING OR 4 AND AGE FACTORS OR 4 AND HOMES FOR THE AGED OR 4 AND HEALTH SERVICES FOR THE AGED OR 4 AND NURSING HOMES SS 7=4 AND ALL GERIATR: OR 4 AND ALL ELDER: OR 4 AND ALL SENIOR# OR 4 AND ALL GERO: SS 8=5 OR 6 OR7 SS 9 = 8 AND AGING (TW) OR 8 AND AGED (TW) OR 8 AND OLDER (TW) OR 8 AND ELDEST (TW) OR 8 AND OLDEST (TW) OR 8 AND SEPTUAGENAR: (TW) OR 8 AND OCTAGENAR: (TW) OR 8 AND NONAGENAR: (TW) OR 8 AND CENTENAR: (TW) SS 10= PSYCHOTROPIC DRUGS SS 11= EXP PHARMACOKINETICS OR PK (SH) SS 12= ALL DEPRESS: (TW) OR AFFECTIVE (TW) OR BIPOLAR (TW) OR UNIPOLAR (TW) OR ALL DYSTHYM: (TW) OR ALL MELANCHOL: (TW) SS 13= 11 AND 12 SS 14= 10 OR 13 SS 15= 14 AND AGED SS 16= 9 OR 15 SS 17= 16 AND NOT ANIMAL GRATEFUL MED® To make online searching easier and more efficient, the Library offers GRATEFUL MED, microcomputer-based software that provides a user-friendly interface to most NLM databases. This software was specifically developed for health professionals and features multiple choice menus and "fill in the blank" screens for easy search preparation. GRATEFUL MED runs on an IBM PC (or IBM- compatible) with DOS 2.0 or a Macintosh, and requires a Hayes (or Hayes-compatible) modem. It may be purchased from the National Technical Information Service in Springfield, Virginia, for $29.95 (plus $3.00 per order for shipping). For your convenience, an order blank has been enclosed at the back of this bibliography. iv ''SAMPLE CITATIONS Citations in this bibliographic series are formatted according to the rules established for Index Medicus®. A sample journal citation appears below. For journal articles written in a foreign language, the English translation of the title is placed in brackets with the language of publication shown by a three letter abbreviation appearing at the end of the citation. Note also that a colon (:) may appear within an author’s name or article title. The NLM computer system automatically inserts this symbol in the place of a diacritical mark. Journal Article: Authors Article Title Small GW, Jarvik LF. Depression in the aged. A commentary. Psychiatr Clin North Am 1982 Apr;5(1):45-8. 4 J/\ \ Abbreviated Journal Date Volume Issue Pages Title ''vi ''TABLE OF CONTENTS page DIAGNOSIS, COURSE, EPIDEMIOLOGICAL AND SOCIAL FACTORS Diagnosis and Phenomenology 1 Medical Comorbidity 4 Epidemiological Aspects 6 Social Factors and Demographic Considerations 8 Natural History, Course, and Outcome 10 BIOLOGICAL ASPECTS Neurochemistry, Neuroanatomy, Biological Markers, and Tests 12 Structural and Functional Imaging Studies 17 TREATMENT Psychosocial Therapies 19 Pharmacotherapy Tricyclic Antidepressants Nortriptyline 20 Others 22 Lithium 24 Psychostimulants 25 Others 26 Electroconvulsive Therapy 29 Miscellaneous Treatment Aspects 31 SPECIAL ISSUES Suicide and Depression 32 Depression in Nursing Homes 33 Substance Abuse and Depression 34 Grief and Bereavement 35 Other Special Issues 36 Vii ''viii ''DIAGNOSIS, COURSE, EPIDEMIOLOGICAL AND SOCIAL FACTORS Diagnosis and Phenomenology Abrams RC, Alexopoulos GS, Young RC. Geriatric depression and DSM-III-R personality disorder criteria. J Am Geriatr Soc 1987 May;35(5):383-6. Addington J, Fry PS. Directions for clinical- psychosocial assessment of depression in the elderly. Clin Gerontol 1986;5(1-2):97-117. Alexopoulos GS. Anxiety-depression syndromes in old age. Int J Geriatr Psychiatry 1990 Nov-Dec;5(6): 351-3. Alexopoulos GS. Heterogeneity and comorbidity in dementia - depression syndromes. Int J Geriatr Psychiatry 1991;6(3):125-7. Alexopoulos GS. Late-life depression and neurological brain disease. Int J Geriatr Psychiatry 1989 Jul- Aug;4(4):187-90. Alexopoulos GS, Young RC, Meyers BS, Abrams RC, Shamoian CA. Late-onset depression. Psychiatr Clin North Am 1988 Mar;11(1):101-15. Ames D, Dolan R, Mann A. The distinction between depression and dementia in the very old. Int J Geriatr Psychiatry 1990;5(3):193-8. Avery D, Silverman J. Psychomotor retardation and agitation in depression. Relationship to age, sex, and response to treatment. J Affective Disord 1984 Aug;7(1):67-76. Baldwin RC. Delusional and non-delusional depression in late life. Evidence for distinct subtypes. Br J Psychiatry 1988 Jan;152:39-44. Bech P, Shapiro RW, Sihm F, Nielsen BM, S:rensen B, Rafaelsen OJ. Personality in unipolar and bipolar manic-malancholic patients. Acta Psychiatr Scand 1980 Sep;62(3):245-57. Berrios GE. Affective disorders in old age: A conceptual history. Int J Geriatr Psychiatry 1991; 6(6):337-46. Berrios GE, Bakshi N. Manic and depressive symptoms in the elderly: their relationships to treatment outcome, cognition and motor symptoms. Psychopathology 1991;24(1):31-8. Bladwin B. Age of onset of depression in the elderly [letter]. Br J Psychiatry 1990 Mar;156:445-6. Blazer D, Bachar JR, Hughes DC. Major depression with melancholia: a comparison of middle-aged and elderly adults. J Am Geriatr Soc 1987 Oct;35(10): 927-32. Blazer DG, Woodbury M, Hughes DC, George LK, et al. A statistical analysis of the classification of depression in a mixed community and clinical sample. J Affective Disord 1989 Jan-Feb;16(1): 11-20. Bolla KI, Lindgren KN, Bonaccorsy C, Bleecker ML. Memory complaints in older adults. Fact or fiction? Arch Neurol 1991;48(1):61-4. Bron B, Wetter-Parasie J. [Changes in the manifestation of guilt perception in endogenous depression in advanced age]. Psychiatr Neurol Med Psychol (Leipz) 1989 May;41(5):257-68. (Ger). Bron B, Wetter-Parasie J. [Changes in the manifestations of endogenous depression in advanced age]. Fortschr Neurol Psychiatr 1989 Jun;57(6):228-37. (Ger). Burvill PW, Hall WD, Stampfer HG, Emmerson JP. A comparison of early-onset and late-onset depressive illness in the elderly. Br J Psychiatry 1989 Nov; 155:673-9. Chandler JD, Gerndt J. Memory complaints and memory deficits in young and old psychiatric inpatients. J Geriatr Psychiatry Neurol 1988 Apr- Jun; 1(2):84-8. Clark DC, Clayton PJ, Andreasen NC, Lewis C, Fawcett J, Scheftner WA. Intellectual functioning and abstraction ability in major affective disorders. Compr Psychiatry 1985 Jul-Aug;26(4):313-25. Conwell Y, Nelson JC, Kim KM, Mazure CM. Depression in late life: age of onset as marker of a subtype. J Affective Disord 1989 Sep-Oct;17(2): 189-95. Craig TJ, Bregman Z. Late onset schizophrenia-like illness. J Am Geriatr Soc 1988;36(2):104-7. Cutler NR, Post RM. Life course of illness in untreated manic-depressive patients. Compr Psychiatry 1982 Mar-Apr;23(2):101-15. Davidson JR, Woodbury MA, Zisook S, Giller EL Jr. Classification of depression by grade of membership: a confirmation study. Psychol Med 1989 Nov;19(4):987-98. Dhingra U, Rabins PV. Mania in the elderly: a 5-7 year follow-up. J Am Geriatr Soc 1991 Jun; 39(6):581-3. ''2 Fogel BS, Westlake R. Personality disorder diagnoses and age in inpatients with major depression. J Clin Psychiatry 1990 Jun;51(6):232-5. Fortin L. 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Futterman A, Gallagher D, Thompson LW, Lovett S, Gilewski M. Retrospective assessment of marital adjustment and depression during the first 2 years of spousal bereavement. Psychol Aging 1990 Jun;5(2): 277-83. Gallagher DE, Breckenridge JN, Thompson LW, Peterson JA. Effects of bereavement on indicators of mental health in elderly widows and widowers. J Gerontol 1983 Sep;38(5):565-71. Gallagher DE, Thompson LW, Peterson JA. Psychosocial factors affecting adaptation to bereavement in the elderly. Int J Aging Hum Dev 1981-82;14(2):79-95. Gilewski MJ, Farberow NL, Gallagher DE, Thompson LW. Interaction of depression and bereavement on mental health in the elderly. Psychol Aging 1991 Mar;6(1):67-75. 35 Goldberg EL, Comstock GW, Harlow SD. Emotional problems and widowhood. J Gerontol 1988 Nov; 43(6):S206-8. Houts PS, Lipton A, Harvey HA, Simmonds MA, et al. Predictors of grief among spouses of deceased cancer patients. J Psychosoc Oncol 1989;7(3): 113-26. 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Waddington JL, Youssef HA. Tardive dyskinesia in bipolar affective disorder: aging, cognitive dysfunction, course of illness, and exposure to neuroleptics and lithium. Am J Psychiatry 1988 May;145(5):613-6. Waxman HM, Carner EA, Blum A. Depressive symptoms and health service utilization among the community elderly. J Am Geriatr Soc 1983 Jul; 31(7):417-20. 37 ''''®) GRATEFUL MED~ Software For Macintosh & IBM === Please send me Please send me , copies of GRATEFUL a copies of GRATEFUL _.__,' MED for the he MED for IBM and ces | Macintosh. eee —- compatibles. ——— Order No. PB89- = ee Hi Order No. PB86- 196083/GBB at $29.95 5, _158482/GBB at $29.95 each. . RS each. Total Mac versions + Total IBM versions + Handling $3.00 + Billing Fee* = Total P.O. #: * Add $7.50 Billing Fee if using a Purchase Order. Please attach this form to any purchase order you use. 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