認識老人憂鬱症－－精神科臨床住院老人之分析報告

An Analyzed Report on the Psychiatric Inpatient Elderly with Geriatric Depression

本文目的是認識精神科住院老人憂鬱症之臨床實況，以南部某一醫學中心之急性精神科病房，90年1月至8月之住院患者，年齡在65歲以上且出院診斷（DSM Ⅳ）為憂鬱症之26名患者對象，以回溯性之設計，對二位精神科住院醫師入院評估所收集在病歷之相關資料作分析統計，呈現與老人憂鬱症之相關因素、誘因、症狀等，結果發現身體疾病、生活事件是主要誘發老人憂鬱症之主因，有近半數老人處在家庭失和之狀態，缺乏有效之家庭支持系統，在症狀方面以想死念頭、失眠、身體不適之抱怨為最多，建議加強社區之老人憂鬱之篩檢、辨識憂鬱症之徵兆及早防範與治療、加強社區之護理，如強化老人身心衛生講座、增進老人之家庭溝通與社會支持網路之運用是迫切需要。

The purposes of this study were to understand the inpatient elderly with depressive disorders. Retrospective research design was used. The subjects over 65 years of age and diagnosed as depression disorder based on DSM-Ⅳ were enrolled from the acute psychiatric ward of one medical center in southern Taiwan. Data were collected from January 2001 to August 2001. The total qualified subjects were 26. Two psychiatrists using structured admission note record data. The descriptive analysis was applied to analyze these data. In this paper, we introduce and discuss about related factors, predisposing factors, and symptoms of geriatric depression. Physical illness and stressful life events were most strongly associated with depression. Nearly half of the subjects are related to domestics and did not have effective family support system. The major complaints of depression were idea of suicide, sleep disturbance, and somatic discomfort. It was suggested to emphasize the screen of geriatric depression in the community in order to prevented beforehand and further management. It was urgency to strengthen the Nursing care of community, such as lecture for mental health, and to promote family communication and social support system of the elderly.The results of this report may act as clinical guidelines for caring elderly with depression.