Depression in Older Adults: Psychological and Psychosocial Approaches

Correspondence to Margaret A. Fielden, Burton District Hospital Centre, Belvedere Annexe, Lower Outwoods Road, Burton-on-Trent, S.E. Staffs. Summary Depression is a commonly experienced psychiatric disorder inthe adult population. The elderly require special considerationsince they show higher prevalence rates than younger adults,high levels of re-occurrence, and a different presentation ofsymptoms. This suggests a need to understand depression in theelderly within a psychological frame and within a psychosocialsetting, where symptoms and themes express the physical, social,and emotional losses of ageing and age-associated developmentaltasks of role change, accepting dependence, and preparing fordeath. An effective therapeutic approach must encompass physical, social,and psychological care. Psychological and psychosocial responsesto depression in the elderly are reviewed here in terms of theirsensitivity to issues of ageing and their preventative valuein minimizing vulnerability to depression.