老年期抑郁障碍的临床特征及诊治进展

老年期抑郁障碍(late life depression,LLD)已经成为老年人群常见的精神心理疾病。LLD患者临床表现复杂多样,且常伴有躯体疾病。临床应指导老年人群使用患者健康问卷-2(patient health questionnaire-2,PHQ-2)自评量表进行抑郁症状筛查,结合躯体症状对筛查阳性人群进行综合评估,并根据第10次修订国际疾病分类(international classification of diseases-10,ICD-10)诊断标准进行定性诊断,为LLD患者的及时治疗奠定基础。心理治疗与药物治疗是该类患者的一线治疗方案,极重度患者可进行电休克治疗,同时应积极治疗躯体疾病和改善生活方式。本文主要针对LLD的临床特征、筛查和评估及诊治的研究进展进行综述,为LLD的综合管理和防治提供参考。

Research progress of clinical features and therapy of late life depression

Late life depression (LLD) has become one of the most common mental and psychological diseases in the elderly. The clinical manifestations of LLD patients are complex and varied, and often accompanied by physical diseases. Clinicians should actively guide the elderly population to use the patient health questionnaire-2 (PHQ-2) self-rating scale to screen depressive symptoms, comprehensively evaluate the positive population combined with physical symptoms, and make definitive diagnosis according to the international classification of diseases-10 (ICD-10) diagnostic criteria, in order to offer the foundation for timely treatment of the LLD patients. Psychotherapy and drug therapy are first-line treatments for the patients, and the severe patients can be treated with electroconvulsive therapy. Meanwhile, the patients should focus on the treatment of physical illnesses and improvement of lifestyles. This article reviews the clinical features, screening, evaluation, diagnosis and therapy progress of LLD, and provides reference for the integrated management and prevention of LLD.