Prognosis of depression in the elderly

Depressive syndromes are, with dementia, the most frequent psychiatric disorders in the elderly. The etiology of depressive syndromes can be reactive, endogenous, and neurotic as well as organic. Recent studies could show, that about 60% of the elderly patients clearly improve under treatment. Therefore the earlier opinion of a dramatically poorer outcome has to be revised. The presence of simultaneously occurring somatic illness, positive family history, certain personality traits and severity of disease could exert a bad influence on clinical outcome. Medical treatment should consider the special pharmacological features in higher age, and should be combined with psychotherapy as well as a close involvement of the relatives.