ABSTRACT
This chapter discusses syndromes that include major depression, bipolar disorder and dysthymia which between them affect about 6% of the population aged 65 and over, and the 'subsyndromal' but still significantly disabling depressions which may affect as many as a further 14%. The presentation of bipolar disorder may be particularly confusing in the case of older people with bipolar disorder during manic or mixed episodes. Manic episodes represent a substantial minority of episodes of affective disorder of sufficient severity to warrant inpatient hospital care. The diagnosis of depression in old age may be obscured by the presence and indeed prominence of anxiety symptoms. The clinical features of depression identified with the standard classificatory systems such as The International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders may still be used for older people but are more problematic in this group.
