senile depression

Senile melancholia refers to a mental disorder with first onset in old age, strictly speaking, first onset after 60 years of age, with persistent depressed mood as the main clinical feature. The clinical characteristics are mainly low mood, anxiety, retardation, and numerous somatic discomfort symptoms. The mental disorder cannot be attributed to physical disease or organic brain disease. Most patients have experienced relatively severe life events before onset, and sleep disturbances may occur, including difficulty falling asleep, dream-disturbed sleep, and early awakening. Patients have excessive worry, sigh frequently, feel that the future is bleak and that living is worse than dying, may have strong suicidal ideation, and may make multiple suicide attempts. Many patients may have long-term diseases that are difficult to cure before onset, or the condition may be induced by physical illness. Some patients have no obvious predisposing factors and gradually develop poor concentration, difficulty thinking, dull expression, and significantly decreased recent and remote memory, presenting a dementia-like picture. In addition to the above manifestations, auditory hallucinations, visual hallucinations, visceral discomfort, and delusions may also occur. In terms of diagnosis, the key is to exclude organic brain diseases, depressive states associated with physical diseases, and drug-induced depression. Compared with young patients, the course of the disease is generally longer, with a tendency toward remission and relapse, and some patients have a poor prognosis. Drug treatment is basically the same as for patients in other age groups, but when using antidepressants, attention should be paid to using a single drug as much as possible, with a dose of about half the usual dose.