노년기 기분장애의 정신치료와 정신사회적 치료

Psychotherapy and Psychosocial Therapy for the Geriatric Mood Disorders

Among the mood disorders in the elderly aged older than 65, dysthymia, major depression, and mania constitute the prototypes and depressed mood is the most frequent symptom. The mode of psychotherapy and psychosocial therapy for geriatric depression, which are similar throughout adulhood, include brief dynamic psychotherapy, interpersonal psychotherapy, psychoanalytic psychotherapy and psychoanalysis, supportive psychotherapy, cognitive therapy, family therapy, and group therapy. Psychotherapy alone is of value primarily in dysthymia and major depression. Short-term cognitive therapy, brief dynamic psychotherapy, and interpersonal psychothearapy have been found to be effective, without medications, in high-functioning elders suffering from major depression with minimal or no cognitive impairment. Cognitive-behavioral psychotherapy may be the treatment of choice in the depressed medically ill. Whatever technique is utilized, it is important to be aware of the dynamic issues that are prevalent in geriatric depression patients, as well as the transference and countertransferenc problems that may be aroused.