Guideline 6: Nonpsychotic Major Depressive Disorder

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The experts considered depressed mood, most of the day, every day, markedly diminished interest or pleasure in activities, and recurrent thoughts of death or suicidal ideation or behavior the three most important discriminating features in diagnosing nonpsychotic major depression in an older patient. These three symptoms have consistently been endorsed in studies of depression in the elderly and were considered the most important symptoms in diagnosing depression in an older patient by a survey of experts on the treatment of depressive disorders in older patients.

The experts first-line recommendation for agitated nonpsychotic major depression in an older patient was an antidepressant alone (rated first line by 77%).’ ‹