The Depressive States of Old Age and Their Treatment

Collins, George H (1954) The Depressive States of Old Age and Their Treatment. PhD thesis, University of Glasgow.

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A series of 118 senile patients suffering from depressive states of varying aetiology was treated with Vitamin-B Group therapy with most encouraging results. In certain severely depressed, suicidal and uncooperative patients it was deemed expedient to supplement the Vitamin-B Group therapy with Electric Convulsive Therapy suitably modified. This was found to expedite recovery, and the response to treatment was excellent. No adverse reactions were encountered in any of the patients treated, although some were of advanced age. Therefore age alone should not he regarded as a harrier to treatment. About 40 per cent of the cases under review exhibited signs of malnutrition and avitaminosis, and the response to the routine methods of treatment employed was better in this group than in the remainder of the series. The response to treatment was least promising in cases who exhibited evidence of organic brain involvement, best in patients with depressive symptoms without concomitant physical illness of any kind. The sooner treatment was started after the initial onset of the psychiatric symptoms the better was the prognosis , and the shorter the period of hospitalisation required. It is suggested that the members of the Vitamin-B Group play an essential role in the metabolism of the brain and other tissues, and when these substances are deficient in the diet of aged patients mental symptoms may result. One member, namely Nicotinic Acid, is a powerful but harmless vasodilator whose action extends to the cerebral arterioles, and it produces a considerable increase in the cerebral blood flow. The beneficial action of Nicotinic Acid may be due to the fact that it is essential for carbohydrate metabolism, and it is generally agreed that carbohydrate is the chief foodstuff of the brain. It may fell be that the provision of adequate supplies of the Vitamin-B Group, including Nicotinic Acid, improves the cerebral metabolism, and that this process is aided by the increased cerebral blood flow attributable to the vasodilator action of Nicotinic Acid. This is pure hypothesis, but whatever the true explanation, there seems little doubt that Vitamin-B Group therapy does produce favourable results in the treatment of the Depressive States of Old Age, and that further clinical trial on a large scale is indicated. Little more now remains to be done save to present a special appendix containing some of the laboratory findings and other data collected during the present researches, in the hope that they may prove of some interest to future research workers. In a second appendix is included abbreviated case histories which may be regarded as typical of the various clinical conditions described.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: Clinical psychology, Mental health, Gerontology
Date of Award: 1954
Depositing User: Enlighten Team
Unique ID: glathesis:1954-78957
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 28 Feb 2020 12:09
Last Modified: 28 Feb 2020 12:09

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