A phenomenological comparison of elderly depression and adult depression

摘要

Objective: Phenomenological differences which are seen in elderly depression difficulties in the diagnosis of depression in elderly people. In this study, it was aimed to compare the phenomenological features of elderly depression and adult depression. Methods: This study included 40 patients aged 18-60 years with major depressive disorder (MDD) and 40 patients over 60 years of age with major depressive disorder (MDD). The Structured Clinical Interview for DSM-IV (SCID-I), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Montgomery-Asberg Depression Rating Scale (MADRS), the Brief Psychiatric Rating Scale (BPRS) and the Standardized Mini-Mental State Examination (SMMSE) were applied to the patients. Results: Both groups participating in the study consisted of the patients with moderate depressive symptoms and without psychotic symptoms. There was no difference between the elderly and adult groups with MDD in terms of the HAM-D and HAM-A total scores. The MADRS and BPRS total scores were higher in the elderly group with MDD compared to the adult group with MDD. The HAM-D difficulty in falling asleep, midnight awakening, early morning awakening and hypochondriasis subscores were higher but the HAM-D suicidal ideation subscore was lower in the elderly group with MDD compared to the adult group with MDD. The MADRS total score and the MADRS inner tension and difficulty in sustaining attention subscores were higher but the MADRS suicidal ideation subscore was lower in the elderly group with MDD compared to the adult group with MDD. The rate of the first depressive episode was 40% in the elderly group with MDD and 52.5% in the adult group with MDD, respectively. The history of depression in first-degree relatives was lower in the elderly group with MDD compared to the adult group with MDD. The HAM-D feeling of guilt subscore was lower, however, the HAM-D midnight awakening and early morning awakening subscores were higher in the elderly patients with the first depressive episode compared to the elderly patients with recurrent major depressive episodes. Discussion: Our results show that sleep disturbances, attention problems and hypochondriacal symptoms were higher; however, suicidal ideation was lower in elderly depression compared to adult depression. Our results also show that feeling of guilt in elderly people may give a clue for previous depressive episodes.