[The diagnosis and therapy of depressive syndromes in old age]

Although depressions are the most frequent psychic disorders in the elderly diagnosis is often delayed and differential diagnosis complicated by other functional syndromes. Prevalent somatic symptoms such as somatic dysesthesias, pain, memory disorders and disorders of performance often mislead diagnostic search particularly if depressive alterations of mood are less prominent. Therefore history gains special importance beside physical examination. Three main groups are distinguished: --symptomatic (exogenous) depression --neurotic (reactive) depression --so called tardive depression Detection of nosologic connections is difficult but a prerequisite for a successful therapeutic approach. To this end particular attention should be given to connections between development of depression and history of life and coping with special events of life.