The Complexity and Challenge of Non-Major Depression in Late Life

Abstract

For the most part, research on mood disorders in later life has focused on major depression. It is well known, however, that much of the depressive symptomatology in older people is not captured by this construct. 1 Blazer DG Epidemiology of late-life depression. in: Schneider LS Reynolds CF Lebowitz BD Diagnosis and Treatment of Depression in Late Life. American Psychiatric Press, Washington, DC1994: 9-19 Google Scholar In part, this is because symptoms are of insufficient number or too intermittent to qualify for the diagnosis. 2 Lyness JM King DA Cox C et al. The importance of subsyndromal depression in older primary care patients: prevalence and associated functional disability. J Am Geriatr Soc. 1999; 47: 647-652 Google Scholar However, it also reflects the fact that criteria for Major Depression in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) 3 American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 4th Edition. American Psychiatric Association, Washington, DC1994 Google Scholar do not capture the phenotypic heterogeneity of depression in later life. 4 Caine ED Lyness JM King DA et al. Clinical and etiological heterogeneity of mood disorders in elderly patients. in: Schneider LS Reynolds CF Lebowitz BD Diagnosis and Treatment of Depression in Late Life. American Psychiatric Press, Washington, DC1994: 23-53 Google Scholar , 5 Gallo JJ Rabins PV Anthony JC Sadness in older persons: 13-year follow-up of a community sample in Baltimore, Maryland. Psychol Med. 1999; 29: 341-350 Google Scholar