老年人的抑郁症管理:一篇综述
Rob M Kok1, Charles F Reynolds2
1Department of Old Age Psychiatry, Parnassia Psychiatric Institute, the Hague, the Netherlands.
JAMA
|May 24, 2017
概括
大型抑郁症在老年人中很常见,可以用抗抑郁药物或电疗法治疗. 在老年人中, 心理治疗和运动等非药物选择对轻度至中度抑郁有效.
科学领域:
- 老年精神病学
- 临床心理学
- 药理学
背景情况:
- 抑郁症对老年人的生活质量产生重大影响,随着年龄的增长,抑郁症的患病率也在增加.
- 患有抑郁症的老年人往往同时出现疾病和认知障碍,导致诊断不足和治疗不足.
- 严重的抑郁症影响到5%以上的成年人,另有10-15%的人出现显著的抑郁症状.
研究的目的:
- 审查老年人抑郁症的流行,表现和治疗.
- 突出治疗老年抑郁症的挑战和考虑因素,包括多种药物和不良事件.
- 讨论老年人中轻度至中度抑郁症的基于证据的治疗方案.
主要方法:
- 对老年人抑郁症的文献综述,重点关注治疗的有效性和安全性.
- 对老年抑郁症常见症状,并发症和认知状况的分析.
- 评估药物和非药物治疗方法,包括抗抑郁药,心理治疗和电治疗.
主要成果:
- 在老年人中,抗抑郁药和电治疗是有效的.
- 心理治疗和运动疗法对轻度至中度抑郁症有效,尤其是那些偏爱非药物治疗方法或无法耐受药物治疗的人.
- 患有抑郁症的老年人往往需要谨慎管理,因为多药和药物相互作用的不良反应风险增加.
结论:
- 老年人的严重抑郁症是一种普遍且可治疗的疾病.
- 有一系列的治疗方法,包括药物和疗法,根据抑郁症的严重程度和患者的因素进行选择.
- 使用诸如STOPP/START标准之类的工具来减少多药性治疗对于安全有效的老年抑郁症治疗至关重要.
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