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Appendix: International commentaries
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- By David Ames, Professor of Psychiatry of Old Age, University of Melbourne, Eleanor Flynn, Senior Lecturer in Medical Education, University of Melbourne, Maria Alekxandrova, Associate Professor of Psychiatry, Medical University Pleven, Kaloyan Stoychev, Consultant Psychiatrist, University Hospital Pleven, Kenneth Shulman, Professor of Geriatric Psychiatry, University of Toronto, Ross Upshur, Professor of Primary Care, University of Toronto, Kirsten Abelskov, Old-Age Psychiatrist, Aarhus University Hospital, Kaj Sparle Christensen, General Practitioner, Institut for Almen Medicin, University of Aarhus, Philippe H. Robert, Professor of Psychiatry, Michel Benoit, Psychiatrist Centre Mémoire de Ressources et de Recherche, Nice, Florence Cabane, General Practitioner Nice, Geneviève Ruault, Geriatrician Nice, Helen F. K. Chiu, Professor of Psychiatry, The Chinese University of Hong Kong, D. K. T. Li, Family Physician, Past President Hong Kong College of Family Physicians, Syuichi Awata, Psychiatrist and Director Division of Neuropsychiatry and Center for Dementia, Sendai City Hospital, Akira Honma, Psychiatrist, Tokyo Metropolitan Institute of Gerontology, Els Licht-Strunk, General Practitioner, VU University Medical Centre, Amsterdam, Marijke Bremmer, Consultant Psychiatrist, VU University Medical Centre, Amsterdam, Knut Engedal, Professor of Old-Age Psychiatry, Ullevaal University Hospital, Oslo, Harald Sanaker, Specialist in Family Medicine, Kongsvegen Legesenter, Brummunddal, Nicoleta Tătaru, Senior Consultant Psychiatrist, Forensic Hospital Ştei, Bihor, Monica Bălan, Primary Care Physician Oradea, Alexandru Dicker, Senior Consultant in Internal Medicine Psychiatric Hospital, Nucet, Bihor, Raimundo Mateos, Professor of Psychiatry, University of Santiago de Compostela, Jose Antonio Ferreiro Guri, Specialist in Family and Community, Medicine University of Santiago de Compostela, Tom Campbell, Professor of Family Medicine, University of Rochester, NY, Jeffrey M. Lyness, Professor of Psychiatry, University of Rochester, NY
- Carolyn A. Chew-Graham, University of Manchester, Robert Baldwin, Alistair Burns, University of Manchester
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- Book:
- Integrated Management of Depression in the Elderly
- Published online:
- 18 December 2009
- Print publication:
- 03 April 2008, pp 140-177
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- Chapter
- Export citation
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Summary
The editors summarized the contributions written by colleagues in different parts of the world (Chapter 6) to illustrate the similarities, and occasional differences, in the management of depression in older people described in all the contributions. This appendix allows the reader to read the individual contributions.
Australia
Assessment
This 82-year-old woman is chronically disabled by pain and breathlessness and appears to have become socially disengaged. She has several symptoms of depression, including persistent low mood, loss of energy (which sounds to be out of proportion to her medical state), early morning waking, loss of interest in previously enjoyed activities, and persistent feelings that life is not worth living. The vignette does not provide information about her appetite and weight, concentration, any psychomotor changes, guilt feelings or confidence levels, but even so it is clear that, provided the symptoms have been present for two weeks (and this seems highly likely), she meets both DSM-IV diagnostic criteria for a major depressive episode and ICD-10 criteria for a depressive episode.
Australian health-care system
Within the Australian health-care system, in which specialists are accessible only after referral from a general practitioner (GP), this woman would normally be managed by her GP who in all likelihood will already be engaged in the management of her troublesome osteoarthritis and chronic obstructive pulmonary disease (COPD). She might well attend a respiratory outpatient clinic or rheumatology clinic in a public hospital, or (less likely as fewer than one-third of the elderly have private health insurance) be seeing a private medical specialist with expertise in one or both of these two areas.