Depression: An Ongoing Clinical Challenge

Our October issue of Clinical Geriatrics focuses on several neurological and psychiatric problems including depression in cognitive impairment, depression in stroke, anorexia nervosa, and Parkinson’s disease. This is fitting because October has been designated as National Disability Awareness Month and has within its calendar National Depression Screening Day and World Mental Health Day! At this time of the year, the decline in daylight hours becomes increasingly evident; outdoor activities and social outlets are curtailed for many, and the “winter blues” are fast approaching. It is no surprise that depression is more commonly noted in the coming months in many areas of the country.  

Depression has received a great deal of recent attention in relation to its newly identified prevalence among adolescents. Let us not forget, however, that depression is believed to affect nearly 1 in 10 adults and is considered the single greatest cause of problem disability across the world. One in 4 women is likely to experience significant depression at some time in their lives, and men are also increasingly affected, especially during later life. The mature and older person is at particularly high risk because symptoms are often dismissed as components of other ailments or are just attributed to “aging.” Physicians must not only be able to identify someone who is already depressed but also be able to recognize risk factors for developing depression. Depression may masquerade as other illnesses such as dementia and alcoholism. It can arise out of the hard realities of dealing with another medical condition such as stroke, as our authors Mathews et al discuss. Authors Watson and Steffens also rightly point out that “depression and cognitive impairment go hand-in-hand.” Regrettably, family distress and suicide are all-too-common consequences of unrecognized and untreated depression.

This issue of our Journal will hopefully stimulate all health care professionals to “think” about this often overlooked problem, and to initiate treatment or refer individual patients to a specialist as necessary. We also include articles that offer practical information to those who are caring for persons with Parkinson’s disease and anorexia nervosa. We hope that you will find this issue useful and stimulating. We look forward to your comments.

Steven R. Gambert, MD, AGSF Editor-in-Chief, Clinical Geriatrics Send comments to Dr. Gambert at medwards@hmpcommunications.com.