psychotherapyforlate-lifedepression晚发抑郁的心理治疗

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1、PsychotherapyforLate-LifeDepressionTreatingolderpatientswithMDDpresentsadifferentsetofchallengestotheclinicianthantreatingyoungeradults・Olderpatientsmayhavemorecomorbidmedicalillnessesztakemoremedications,andmetabolizemedicationsmoreslowlythanyoungpatients.Cognitiveimpairment,thelackofas

2、ocialsupportnetwork,problemswithtransportation,financialconstraints,anddisabilitymaybebarrierstoolderpatientsreceivingtreatment.Theseclinicalproblemsmakeitlikelythatolderadultswillbeexcludedfromclinicaltrials,thusleadingtoapaucityofdata-basedtreatmentinformation.Forthisreason,ateamofinve

3、stigators1convenedin2001toaddresssomeoftheclinicalquestionsregardingthetreatmentoflate-lifedepression・Theteamsentawrittensurveyto50nationalexpertsregardingtreatmentoptionsforgeriatricpatients,andconsensuswasreachedbytheexpertsonthemajorityofoptionspresented・Guidelinesbasedonthetreatments

4、trategiespreferredbytheexpertswerethendevelopedtoaidcliniciansintreatingolderpatientswithdepression・Theconsensuswasthatthetreatmentfordysythmicdisorderorpersistentminordepressionshouldconsistofanantidepressantcombinedwithpsychotherapy,orpossiblyeitheranantidepressantorpsychotherapyalone.

5、1/2Thepreferredtreatmentstrategyforunipolarnonpsychoticmajordepressionofanyseveritywasanantidepressantpluspsychotherapy,althoughECTwasalsoconsideredforseveredepressionunresponsivetoantidepressants.2TheSSRIswereconsideredthepreferredantidepressantclass;foranupdateonpharmacotherapy,pleases

6、ee''PharmacotherapyforLate-LifeDepression.〃ThepreferredpsychotherapieswereCBT,supportivepsychotherapy,PST,andIPT.Inaddition,theExpertConsensusGuidelinesaffirmedthatpsychosocialinterventionssuchasfamilycounselingandvisitingnurseservicesareintegralcomporientsoftreatmentprogramsforpatientsw

7、ithlate-lifedepression,alongwithcarefuIscreeningandtreatmentforcomorbidmedicalconditionsthatmightcontributetoorevencausepatients'depression.IndicationsforPsychotherapyasTreatmentforLate-LifeDepressionAlthoughthetreatmentguidelinescallforbothanantidepressantandpsychotherap