Geriatric depression: atypical presentations, hidden meanings

Geriatric patients with affective illness often present with unusual or atypical symptom patterns that make diagnosis difficult. Depression may be masked as pseudodementia, somatization, or anxiety/irritability, or it may be an underlying factor in pain syndromes and alcohol abuse. In the elderly, depression may be a primary or secondary symptom of a concomitant medical condition, including thyroid disease and occult neoplasm. Common medications, including some antihypertensive agents, may also have etiologic significance.