{'fraction_non_alphanumeric': 0.0170299727520436, 'fraction_numerical': 0.0020435967302452314, 'mean_word_length': 5.832558139534884, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Drug treatment for depression in patients inside rehabilitation wards

Editor,—Shah and colleagues report on the prevalence of psychiatric disorders affecting elderly people institutionalised in a rehabilitation unit.1 They conclude that depression is common among older adults, it is a treatable condition, and that in cases where there are cognitive impairments associated with concomitant depression, the cognitive impairments are worsened by the depressive disease. Although the high prevalence of cognitive impairments and depression in these patients is important and it is necessary to call attention to it, I believe that from the psychiatric perspective, the problem has been oversimplified. Therefore, we cannot accept the elementary proposition of Shah et al about a drug trial with selective serotonin reuptake inhibitors (SSRIs) to elucidate the correct diagnosis when diagnostic doubts remain.

Depressive states in older patient groups have a tremendous clinical heterogeneity. Beside the depressive elderly patient without complicated somatic pathology or psychiatric co-morbidity, that will respond adequately to antidepressant drugs, a significant proportion of other symptomatic depressed patients (whose cases are precisely studied by Shah and colleagues in their article) can be considered as follows.

(1) Elderly depressed patients who may show greater cognitive deficits compared with age similar normal subjects.2 These patients also present …