老人憂鬱症與自殺防治

Assessment and Management of Geriatric Depression and Suicide

鄭偉伸(Wei-Shen Cheng) ； 黃宗正(Tzung-Jeng Hwang) ； 李明濱(Ming-Been Lee) ； 廖士程(Shih-Cheng Liao)

《台灣老年醫學暨老年學雜誌》 11卷1期 (2016/02) Pp. 16-30

https://doi.org/10.29461/TGG.201602_11(1).0002

摘要

老人憂鬱症在社區或機構有相當盛行率，不僅引起失能、干擾慢性疾病治療、增加醫療花費，也是老人自殺的危險因子之一。老人憂鬱症的臨床表現除了一般憂鬱症候群外，常伴隨有焦慮、易怒、多重身體抱怨等。對於老人焦慮憂鬱情緒症狀，主動篩檢與後續配套服務連結，是防治工作的一環。老人憂鬱症是可以被有效治療的，治療方式包括：改變生活型態、心理治療、抗憂鬱劑藥物治療或是電痙攣治療法。自殺是多重危險因子造成的悲劇結果，防治老人自殺不應僅僅被簡化為防治老人憂鬱症，老人自殺防治工作還應該包括多層面的介入，例如：限制致命工具可得性，增進社會連結與整合，提供共同照護服務等，以符合當代全面性、選擇性、以及指標性之多層面自殺防治策略。

關鍵字

老人 ； 憂鬱症 ； 自殺 ； 自殺防治

並列摘要

Geriatric depression, a common health problem in community and institute setting, may cause disability, result in higher medical expenditure, disturb treatment of chronic diseases, and increase the risk of suicide. The clinical presentation of geriatric depression could vary from typical depressive syndrome to co-existed anxiety, irritability, and multiple somatic complaints. Active screening and appropriate post-screening services are crucial for the prevention of geriatric depression. Contemporary treatments of geriatric depression, such as lifestyle change, depression-focused psychotherapy, psychopharmacological treatments, and electroconvulsive therapy, have been proved to be effective. Suicide is a tragic endpoint of multiple adversities. Prevention of geriatric suicide should not narrowly focus on the prevention of geriatric depression. Public health interventions with a multidimensional approach are critical, such as restriction of lethal means, appropriate collaborative care, and enhanced social integration. These interventions incorporating indicative, selective, and universal strategies are necessary for suicide prevention in the geriatric population.

並列關鍵字

the aged ； depression ； suicide ； suicide prevention