[Severe and psychotic depression in an elderly person]

Severe depression affects 1 to 4% of the elderly population with symptoms that may differ from those of younger people. Among the elderly, even a severe depressive state has been underdiagnosed and may thus remain untreated. The most severe complication of severe and psychotic depression is suicide, as committed by 162 persons over 65 years of age in Finland in 2008. The treatment of most severe geriatric depressions is often initiated in a psychiatric hospital. Antidepressive drugs may exhibit differences in efficacy within this patient group. Patients should be referred to electroshock therapy at an earlier stage than is currently done.