[Time perspective in the treatment of elderly depressed patients]

Coping with depressive illness in old age is impeded by particular strains: an increasing incidence of loss events, physical constraints, lack of social support and narrowing prospects for the future may lead to relapse as well as retarded recovery or chronification. Treatment directed toward long-term rehabilitation therefore requires, in addition to medical measures, psychotherapeutic and social interventions which help the patient cope with past loss, solve current problems and open up new perspectives for the future. This integration would overcome a dichotomy, still prevalent in psychotherapy for the elderly, between retrospection and life review on the one hand, activation and extension of competence on the other--or "involution" versus "evolution". A therapeutic approach which thus integrates personal aspects of the past, present and future may also combine various methods such as reminiscence therapy, interpersonal therapy, behavioral and social interventions.