Hallucinatory depression in the elderly: a community study

The prevalence of hallucinatory depression and symptoms and the social and health status of hallucinatory depressives were studied in a Finnish population aged 60 years or over. The prevalence was 2 per 1,000 for men, 3 per 1,000 for women and 2 per 1,000 for both sexes. Hallucinatory depressions represented 0.9% of all depressions both in men and women, and 7.7% of major depressions in men, 5.7% in women, and 6.3% in both sexes. The hallucinations included visual and hearing hallucinations. Delayed insomnia and depersonalisation were more severe in hallucinatory depressives than in nonhallucinatory major depressives, but initial insomnia was more severe in nonhallucinatory major depressives. Depersonalisation, paranoid symptoms and delayed insomnia were more severe in hallucinatory depressives than in all nonhallucinatory depressives, but initial insomnia was more severe in all nonhallucinatory depressives. The physical health and functional capacity of hallucinatory depressives were good, but they had suffered from social stress factors before the onset of depression. The results gave some evidence that hallucinatory depression in old age is not a clinical entity separate from other forms of major depression.