Late-Life Depression

• Geriatric Medicine and Psychiatry clinics within the UIC Medical Center. Patients with mood and other psychiatric disturbances are frequently referred by physicians from both geriatric medicine and family medicine for a consultation and sometimes for ongoing psychiatric care.
• Community outreach efforts and recruitment through advertising in newsletters, local newspapers

Inclusion Criteria:

• Age: 60 years or greater
• Diagnosis of major depressive disorder using standard diagnostic and statistical manual (DSM) criteria
• Score of 15 or greater on the 17-item Hamilton Depression rating scale
• Mini Mental Status Exam score of 24 or greater
• No evidence of clinical dementia or any other clinical brain disorder
• Free of psychotropic/psychoactive medications for at least 2 weeks

Exclusion Criteria:

• Presence of dementia or any other clinical brain disorder (Parkinson's, Alzheimer's)
• History of progressive cognitive decline and/or Mini Mental Status Exam score of less than 24
• Lifetime diagnosis of substance abuse
• Unstable medical illness (grade 4 on the Cumulative Illness Rating Scale)
• Presence of any metallic implant that would preclude an MRI scan (pacemaker, etc.)
• Concurrent Axis 1 disorder (schizophrenia, bipolar)
• Psychotropic medication implicated in depression i.e. Reserpine, Alpha methyl dopa, Beta blockers, multiple long acting benzodiazepines (valium, flurazepam, chlordiazepoxide), neuroleptics;
• Seizure disorder
• Stroke/Transient Ischemic Attack
• Central nervous system disorder (Parkinson's disease, multiple sclerosis)
• Trauma to head/Loss of Consciousness
• Claustrophobia
• Eating disorder (anorexia, bulimia)
• Weight of over 350 pounds
• Learning disorder (dyslexia, ADHD)
• Psychosis, panic or anxiety disorder outside the context of depression
• Mood stabilizing agents such as lithium and Divalproex sodium and antidepressants - as they have been shown to impact on brain levels of NAA, Ch and Ml