The Study Of Late-life Depression Pathogenesis And Differential Diagnosis

Introduction:Depression in late life (>60 years old) is one of the most common psychiatric disorder in the elderly with clinical presentation of depressed mood or anhedonia (an inability to experience pleasure). From the TCM perspective, it has been classified under 'Depression', 'Mental Unwellness', 'Fatigue' category. As late-life depression is a common psychotic disorder in the elderly, thus it would be of great value to look into research from TCM perspective on the pathogenesis and unique treatment for the illness.The root cause of depression is complex, thus till to-date, it has yet to be identified. A more consistent view is that the incidence of biological factors constitute to the tendency while the psychological and the social factors play the role of triggering the media .The pathological changes of depression with the central nervous system, immune and neuro-endocrine function related to the exact pathogenesis is not clear. Presently there is a dispute over numerous hypotheses including the monoamine hypothesis, the neurotransmitter receptors hypothesis, the neuro-endocrine function hypothesis and the abnormal immune system hypothesis. At present in the Western clinic, the commonly used antidepressant drugs include tricyclic, the fourth ring category, neurotransmitter inhibitors, monoamine Oxidase inhibitors and other drugs. The clinical application of such drugs is being restricted due to its side-effects, poor efficacy, poor compliance and high costing. As depression is a complex illness resulted from biological, psychological and social factors, it could create human multi-system and multi-level pathological responses. Thus a single, clear target of drug therapy would inevitably have some shortcomings and widespread adverse reaction and relapses cases as compared to a multi-level, multi-target Chinese Medicine treatment regime, the later has it advantages. TCM has an earlier awareness of depression with the related exposition recorded in the ancient Chinese Medical Books. Though there is no name of 'depression' in the ancient Chinese Medical Books, but there is a rich account of the etiology, pathogenesis and treatment of depression. TCM classified depression as an emotional illness described as melancholia.In medicine will be mainly in its scope of the more to the ancient literature of the Melancholia. From "during the " five- yu of the five elements of the natural gas will be the five internal organs of the body changes and the impact of the organic combination of the gas. though Wu Zhe Chen 'Yu' doctrine, Dan Xi Six Zhu Yu said, gradually expanded the pathogenesis of the melancholia and treatment content. Ming Zhang Jing Yue, "Jing Yue Book" Melancholia out of the chapter, be systematically explained, for the treatment of Melancholia later laid the foundation. From inspection history of depression awareness of Chinese medicine, pointed out many vulnerable viewpoints and understanding, left with future generations a great wealth of dialectical thinking. Modern Chinese Medicine clinical study of depression includes etiology detecting pathogenesis, treatment based on the differential diagnosis and using of Chinese medicine. The study outcome on Chinese medicine shows to be more superior as western medicine produces adverse reaction in treating growing number of depression cases.Causation of Late- life Depression with main clinical presentation in following 3 aspects:A combination of Weakness Kidney's Hepatic Qi and Spleen's Hepatic Qi, resulting in More Qi, Phlegm and 'Yu' and interchanging with Weakness and 'Shi'. Treatment Regime of Late- life Depression includes alternative treatment perspectives such as providing a combination of TCM medicine, acupuncture and counseling support into treating late-life depression. To summarize, the research is based on empowering Zang—hepatic qi and yin-yang from the spleen, kidney, liver perspectives incorporating the use of TCM medicine and acupuncture to treat late-life depression.