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Masked Depression

Abstract: Is it possible to have depressed elderly patients who do not appear to be distressed?

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Masked Depression

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Question(s): 
Written by: Petros Skapinakis, MD, MPH, PhD, lecturer of Psychiatry in the University of Ioannina Medical School, Greece. Eva Gerasi, postgraduate student in the Department of Psychiatry, University Hospital of Ioannina, Greece.
First version: 22 Jul 2008.
Latest revision: 29 Jul 2008.

Is it possible to have depressed elderly patients who do not appear to be distressed?

Answer:

Absence of the usual appearance of low mood should not preclude a diagnosis of depression. Whether because of a wish to avoid becoming a burden or because of the determination of the current cohort of the elderly to "put a brave face upon it", late life depression can be masked by a smiling visage. "Masked depression" is a rather old-fashioned term but does seem to apply to a particular group of older people with depression. This does not prevent the experienced from searching for other signs and symptoms of depression.
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