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Appendix: International commentaries

Published online by Cambridge University Press:  18 December 2009

Carolyn A. Chew-Graham ,
Robert Baldwin  and
Alistair Burns
By
David Ames ,
Eleanor Flynn ,
Maria Alekxandrova ,
Kaloyan Stoychev ,
Kenneth Shulman ,
Ross Upshur ,
Kirsten Abelskov ,
Kaj Sparle Christensen ,
Philippe H. Robert  and
Michel Benoit
...Show all authors
Carolyn A. Chew-Graham
Affiliation:
University of Manchester
Robert Baldwin
Affiliation:
Manchester Mental Health and Social Care NHS Trust
Alistair Burns
Affiliation:
University of Manchester
David Ames
Affiliation:
Professor of Psychiatry of Old Age, University of Melbourne
Eleanor Flynn
Affiliation:
Senior Lecturer in Medical Education, University of Melbourne
Maria Alekxandrova
Affiliation:
Associate Professor of Psychiatry, Medical University Pleven
Kaloyan Stoychev
Affiliation:
Consultant Psychiatrist, University Hospital Pleven
Kenneth Shulman
Affiliation:
Professor of Geriatric Psychiatry, University of Toronto
Ross Upshur
Affiliation:
Professor of Primary Care, University of Toronto
Kirsten Abelskov
Affiliation:
Old-Age Psychiatrist, Aarhus University Hospital
Kaj Sparle Christensen
Affiliation:
General Practitioner, Institut for Almen Medicin, University of Aarhus
Philippe H. Robert
Affiliation:
Professor of Psychiatry
Michel Benoit
Affiliation:
Psychiatrist Centre Mémoire de Ressources et de Recherche, Nice
Florence Cabane
Affiliation:
General Practitioner Nice
Geneviève Ruault
Affiliation:
Geriatrician Nice
Helen F. K. Chiu
Affiliation:
Professor of Psychiatry, The Chinese University of Hong Kong
D. K. T. Li
Affiliation:
Family Physician, Past President Hong Kong College of Family Physicians
Syuichi Awata
Affiliation:
Psychiatrist and Director Division of Neuropsychiatry and Center for Dementia, Sendai City Hospital
Akira Honma
Affiliation:
Psychiatrist, Tokyo Metropolitan Institute of Gerontology
Els Licht-Strunk
Affiliation:
General Practitioner, VU University Medical Centre, Amsterdam
Marijke Bremmer
Affiliation:
Consultant Psychiatrist, VU University Medical Centre, Amsterdam
Knut Engedal
Affiliation:
Professor of Old-Age Psychiatry, Ullevaal University Hospital, Oslo
Harald Sanaker
Affiliation:
Specialist in Family Medicine, Kongsvegen Legesenter, Brummunddal
Nicoleta Tătaru
Affiliation:
Senior Consultant Psychiatrist, Forensic Hospital Ştei, Bihor
Monica Bălan
Affiliation:
Primary Care Physician Oradea
Alexandru Dicker
Affiliation:
Senior Consultant in Internal Medicine Psychiatric Hospital, Nucet, Bihor
Raimundo Mateos
Affiliation:
Professor of Psychiatry, University of Santiago de Compostela
Jose Antonio Ferreiro Guri
Affiliation:
Specialist in Family and Community, Medicine University of Santiago de Compostela
Tom Campbell
Affiliation:
Professor of Family Medicine, University of Rochester, NY
Jeffrey M. Lyness
Affiliation:
Professor of Psychiatry, University of Rochester, NY
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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.

Type
Chapter
Information
Integrated Management of Depression in the Elderly , pp. 140 - 177
Publisher: Cambridge University Press
Print publication year: 2008

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