Chapter
The aetiology of depression in later life
Presentation of depression in later life
Clinical presentation of depression in later life
Making the diagnosis of depression in later life
Depression in older people from different ethnic groups
Prevalence and risk factors for depression
Symptoms and course of depression
Considerations in the assessment
Depression screening scales for ethnic elders
2 Management of late-life depression
General principles of treatment
The stepped care approach to the management of depression
Practical considerations of the stepped care approach
The collaborative care approach
Initiating treatment with an antidepressant
Side effects of medication
Patients who do not respond
Sources of treatment variability in older patients
Psychological interventions
3 Management of late-life depression in primary care: case studies UK
Case 3.1 A request for sleeping tablets
Eliciting Mr SY’s perspective
Assessing mood and eliciting symptoms of depression
Assessing physical problems
Case 3.2 Loneliness and grief
Grief, complicated grief or depression?
Social and personal context
Examination and investigations
The Positive Thoughts course
4 Management of more complicated depression in primary care: case studies UK
Case 4.1 Hidden alcohol consumption
The aim of the assessment
Assessment of the alcohol problem
Assessment of physical health
Treatment for alcohol problems
Addressing underlying factors
Case 4.2 Physical co-morbidity
Collaboration between primary and secondary care
Barriers to effective management
Case 4.3 Carers and families
Barriers and facilitating factors
Case 4.4 Ethnically sensitive management
Supporting professionals and commissioners of mental health services
5 Management of late-life depression across primary and secondary care: case studies UK
Case 5.1 Depression with psychotic features
Case 5.2 Risk of self-harm
Case 5.3 Depression and forgetfulness
6 Management of late-life depression around the world: summary of international commentaries
International commentaries for the integrated management of depression
Case 6.1 Breathlessness and irritability
The presentation of depression
Barriers to effective treatment of older depressed patients
Protocols, guidelines and initiatives
Screening for depression in older people
Practice guidelines (practitioner resources)
Patient education material
Relevant literature and online resources
Self-help material and groups
Services for older people with depression
Appendix: International commentaries
Australian health-care system
Roles of primary and secondary care
Canadian health-care system
Guidelines for assessment and management of depression in Canada
Referral to secondary care
The Danish health-care system
Presentation of depression
First-line drug treatment
Barriers to effective treatment
Barriers to effective management
Health-care system in Hong Kong
Barriers to effective treatment
The Dutch health-care system
The role of the psychiatrist
Norwegian health-care system
Mental health-care system in Romania
Spanish health-care system
Presentation of depression