Psychosocial stress factors and the prevention of depressive illness in the elderly.

An intensive investigation was launched to determine the relationship between psychosocial factors and depressive illness in the elderly. A group of known psychiatric patients with a history of depressive illness was compared with a control group of clients of welfare organizations. The aim was to determine guidelines for preventive psychogeriatric services, particularly with regard to depressive illness, which would then give an indication as to which one of two hypothetical propositions would probably be most applicable to the specific elderly population for which Stikland Hospital, Bellville, is formulating a preventive programme. It was found that psychosocial factors play a relatively unimportant role in the genesis of depressive illness in the senium. Constitutional predisposition probably plays a larger or at least equally important role. A well-planned selective programme of secondary prevention, i.e. the early finding and treatment of depressed elderly persons, combined with a programme of primary prevention with regard to psychosocial stress factors and confined to elderly people at high risk for depressive illness, would probably yield better results at lower cost.