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| | THE MERCK MANUAL OF GERIATRICS, Ch. 33, Depression |
 | | Melancholia is present if these symptoms are predominated by a lack of interest in the social environment, diurnal variation (ie, feeling significantly worse during one part of the day, usually the morning, compared with the remainder of the day), and psychomotor agitation or retardation. |
 | | During a manic episode, a person may experience an inflated self-esteem, decreased need for sleep, increased talkativeness, a subjective sense that thoughts are racing, distractibility, psychomotor agitation, and involvement in activities that are perceived to be pleasurable but that can lead to adverse outcomes, such as unrestrained buying. |
 | | For example, if the elderly person has had previous episodes of depression associated with psychomotor retardation and, over a short period of time, enters an episode of acute agitation, decreased sleep, and increased talkativeness, a manic episode is likely even if the mood is dysphoric. |
| www.merck.com /mrkshared/mmg/sec4/ch33/ch33a.jsp (2637 words) |
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