By C L E Katona; Gill Livingston
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Are you basically satisfied with your life? Y/N Do you often get bored? Y/N Do you often feel helpless? Y/N Do you prefer staying at home rather than going out and doing new things? Y/N 5. Do you feel pretty worthless the way you are now? Y/N Underlined answers score 1 point. Scores of ≥2 indicate probable depression. Prevalence, clinical presentation and prognosis Depressive symptoms occur in as many as 50% of older people on general hospital wards, although reported rates depend crucially on age, sex, type of ward and threshold for identifying depressive ‘caseness’.
Angiotensin-converting enzyme (ACE) inhibitors, diuretics (especially thiazides) and non-steroidal anti-inflammatory drugs (with the exception of aspirin) may all enhance lithium toxicity by reducing its excretion by the kidney. The combination of verapamil and lithium may cause both neurotoxicity and bradycardia. Lithium toxicity commonly occurs in older people for a variety of reasons, including erratic compliance, co-administered drugs and deteriorating renal function. It can rapidly become life threatening.
There may also be excessive reluctance to use potentially dangerous treatments. 03 02/09/2002 3 14 pm Page 37 Co-morbid depression 37 Box 15 The 5-item Geriatric Depression Scale for use in people with comorbid physical illness (From Hoyl et al, 1999) 1. 2. 3. 4. Are you basically satisfied with your life? Y/N Do you often get bored? Y/N Do you often feel helpless? Y/N Do you prefer staying at home rather than going out and doing new things? Y/N 5. Do you feel pretty worthless the way you are now?