Conduites addictives du sujet âgé : masque d'une dépression ou issue psychopathologique spécifique ?

Case reports, epidemiological data and sociological findings, notably the lower prevalence of addictive disorders in older patients, together with supporting notions about the psychopathology of aging and frequently observed addictive behaviors (whether involving an object of choice, e.g. highly prevalent alcohol abuse, or more unobtrusive or even concealed behaviors) suggest that such behavior might play an important role in the mental working of the older patient. Several hypotheses can be put forward: first the classical hypothesis of addiction as a mask or reaction to depression connected with aging-related loss, and second a specific addiction of the frail elderly favoring attachment to mental images rather than an external object or a peculiar behavior. Problematics such as the middle age crisis, the links between creative and addictive processes, or regressive and hypochondriac or behavioral phenomena such as Diogene's syndrome specific to this age range, illustrate or support the hypothesis of an alternative to classical addiction. Categories of addiction inherent and specific to aging can be described.