全球健康疾病負擔統計(global burden of disease) 發現憂鬱症是第二名，雖然健康且能獨 立生活的社區中老年人有憂鬱症狀的盛行率不似一般成年人高，也有文獻發現中老年憂鬱症 (late-life depression) 其實常被低估，美國統計發現老年男性卻是被低估的族群之一。如果合併 多重疾病，中老年人有憂鬱症狀的盛行率將大幅提高。憂鬱症是自殺(suicide) 的危險因子，統 計發現老年人自殺成功的比例比年輕人高。中老年憂鬱症近年也發現與認知功能衰退有共病或 因果關係。文獻得知患者若罹患某些內科疾病後，一旦罹患憂鬱症會增加死亡率。台灣過於次 專科化的醫療體系在經歷SARS 衝擊之後所衍生的畢業後一般醫學訓練(PGY) 強調全科訓練 的現代，加上台灣已步入老化(aging) 社會的時代，衛生福利部自2015 年7 月起推廣“專責住 院主治醫師照護制度”，臨床醫護人員若能在臨床實務上提升覺察中老年憂鬱症狀的能力，將 有助於中老年憂鬱症的正確診斷及適當轉介處置，對內外科疾病的控制也會有幫助。

Depression is the 2nd cause among the global burden of disease. The prevalence rate of late-life depression among healthy and independently elder residents in community is lower than younger adults, but the prevalence of depression in older age may be underestimated. The prevalence rate of late-life depression will be higher as more comorbidity happened. Depression is the risk factor of suicide, and the rate of completed suicide in the older group is higher than the younger group. Besides, more and more studies clamed that depression is associated with cognitive impairment. In addition, if the patients with some medical illness once suffer from depression, they will meet higher mortality. So how to find out the potential risk group of depressed older patients is the important issue in daily practice regardless of out-patient clinic or admission. Therefore general physician training is getting important in the aging society nowadays especially after the threatening of SARS in Taiwan. If we could aware the risk group of late-life depressive patients more practically, the prevention of depression even suicide will be more practically managed and the prognosis of physical comorbidity will be easier treated.