Citation

Hölzel LP, Härter M, Hull M. Nervenarzt, Der 2017; 88(11): 1227-1233.

Copyright

(Copyright © 2017, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00115-017-0407-y

PMID

28871311

Abstract

Mental disorders contribute substantially to the loss of quality of life and life expectancy in old age. Life expectancy is reduced especially by the bidirectional interaction with heart diseases, diabetes mellitus as well as the depression-specific risk of suicide. Depression in old age is a strong risk factor for nursing home placement, which is usually an undesired outcome for older people. Utilization of mental health services is hindered by self-stigmatization and prejudice; however, according to recent surveys older people increasingly value psychotherapeutic services. Shortcomings in the diagnostics and therapy in the primary treatment of old age depression have stimulated research in low-threshold options in primary care and collaborative multiprofessional outpatient interventions in many countries. The core features of collaborative care approaches are improved diagnostics, stepped-care protocols, continuous disease monitoring, and access to psychiatric and psychotherapeutic supervision or services. Collaborative multiprofessional outpatient approaches have been shown to be superior for the treatment of old age depression compared to treatment as usual.

Language: de

Keywords

Humans; Aged; Suicide; Patient Care Team; Health Services Accessibility; Quality of Life; Patient Acceptance of Health Care; Ambulatory Care; Depressive Disorder; Mental Disorders; Guidelines; Interdisciplinary Communication; Nursing home; Patient Care Management; Intersectoral Collaboration; Old age depression; Structured treatment