Study On Clinical Manifestations Of First-onset Elderly Depression

Objective:The purpose of the study is to investigate the clinical features of the first-onset elderly patients with depression by way of comparing the difference between the elderly patients and the young patients on the aspects of etiology, clinical manifestations and treatment outcomes.Methods:Sixty elderly patients with first-onset depression were included to the study who met the CCMD-3 criteria for depression . Sixty young patients with first-onset depression were selected as controlled subjects. Symptom Checklist (SCL-90), Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA) and the Minnesota Multi-phasic Personality Test (MMPI) were employed to evaluate the depressive and related symptoms .SSRIs were used to treat depression for 8 weeks. The evaluation of HAMD was conducted on 1, 2, 4, 8 weeks after the beginning of antidepressive treatment. The self-made questionnaire was used to analyze the predisposing factors of depression and to get the related information needed.. Results:1. Etiology: In the first-onset elderly patients group , of which 73.3% was induced by psycho-social factors. But in the young patients , just 50% of which was induced by psycho-social factors. The difference beween the two groups is statistically significant. Among the top psycho-social factors are marital state , financial security (health insurance), living alone, negative life events as well as physical disease.2. Clinical manifestations: The most common initial symptom of the first-onset elderly depression is physical complaints. The HAMD total score , anxiety /somatization scores of the first-onset elderly depression are significantly higher than that of the first-onset younger patients with depression. But as for the scores of sleep disorders, weight loss and diurnal variation, the first-onset elderly patients with depression are significantly lower than the first-onset younger depression. The HAMA total score, body factors of first-onset elderly patients with depressions are significantly higher than the first-onset younger depression. The factor scores of depression and Pd mental illness in MMPI are significantly lower than the younger depression. The somatization score in SCL-90 for the elderly depression are significantly higher than the younger depression.3. Treatment outcomes: After 8 weeks treatment of SSRIs, The cure rate of the elderly patients with depression is 51.7%, Which was significantly lower than that of the young patients with depression. The difference between the groups was statistically significant.Conclusions:The elderly depression are usually induced by psycho-social factors such as no marriage (partner), poor economic state, living alone, negative life events and physical disease.The most common initial symptoms of the elderly depression is physical complaints. Symptoms such as anxiety, hypochondria, memory loss and physical complaints was seen more common in the elderly depression than in the young depression. But the biological symptoms appeared less common in the elderly depression. The efficacy of SSRIs is worse for the elderly depression than for the young depression.