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Short Communication | DOI: https://doi.org/10.31579/2578-8868/403
Neurobiology of Anxiety and Mood Disorders, Nantes University, 98 rue Joseph Blanchart, 44100 Nantes, France.
*Corresponding Author: Michel Bourin, Neurobiology of Anxiety and Mood Disorders, Nantes University, 98 rue Joseph Blanchart, 44100 Nantes, France.
Citation: Michel Bourin, (2026), Diagnosis and Treatment of Depression in the Elderly, J. Neuroscience and Neurological Surgery, 19(2); DOI:10.31579/2578-8868/403
Copyright: © 2026, Michel Bourin. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Received: 20 February 2026 | Accepted: 26 February 2026 | Published: 10 March 2026
Keywords: late-life depression, elderly; diagnosis; treatment; psychotherapy; pharmacotherapy; electroconvulsive therapy; dementia; suicide prevention
Background:Depression frequently impacts older adults, yet it often goes unnoticed, significantly affecting their overall health and quality of life. Unlike in younger individuals, depression in the elderly may show up as physical complaints, cognitive problems, or anxiety, which complicates diagnosis due to similarities with other medical or age-related issues.Methods:This review highlights recent findings on how often depression occurs among older adults, its symptoms, challenges in identifying it, and current treatment options. It also examines connections with dementia, suicide risk, and available therapies.Results:Depression in older adults is frequently overlooked because its symptoms can be unusual or may coincide with other medical or cognitive problems. Depression late in life is closely linked to an increased likelihood of disability, higher suicide rates, and a greater chance of developing dementia. Research indicates that psychotherapy, medication, and electroconvulsive therapy can be effective treatments. Nonetheless, it is important to tailor treatment plans to reflect everyone’s physical changes and present health status.Conclusions:Better recognition and personalized treatment approaches for depression in older adults can notably improve outcomes, reduce suffering, and help prevent suicide. Greater awareness among healthcare professionals and routine use of screening and evidence-based treatments are crucial for tackling this urgent public health problem.
The World Health Organization (WHO) now reports that unipolar depression is the leading cause of illness and disability across the globe, affecting about 16% of people at some point in their lives. In older adults, depression rates are even higher ranging from 20.3% in those with normal cognition to 65.1% in individuals with dementia [2]. Depression later in life brings serious declines in quality of life, greater dependence, increased use of healthcare services, and a greater risk of early death, especially from heart disease and suicide [3,4]. Although depression significantly affects both individuals and society, it frequently goes undiagnosed and untreated in older adults. This often happens when depression shows up with physical symptoms instead of emotional ones, leading it to being confused with other illnesses or just considered part of getting older. Using only benzodiazepines to treat anxiety-related symptoms without addressing underlying depression can further mask the problem and introduce additional dangers, such as cognitive decline, falls, and dependency [6]. Diagnosing depression in older adults is even harder due to widespread multimorbidity, overlapping cognitive decline, multiple medications, and stressors like bereavement, loss of independence, or financial hardship [7]. Importantly, depressive symptoms in older adults are frequently mistaken for a normal aspect of aging, which can result in postponing or missing out on appropriate treatment [8]. Many older patients do not directly report feeling depressed, instead of coming to doctors with vague physical complaints, tiredness, or memory issues that can hide an underlying mood disorder.
Neurobiological changes associated with aging may also alter the clinical expression of depression, reduce the prominence of classical features such as sadness or guilt and increase the prevalence of psychomotor retardation, anxiety, and cognitive symptoms. Notably, untreated depression in this population confers a substantial risk of suicide, particularly among older men a demographic with among the highest suicide rates globally [9].
Given its high prevalence, diagnostic complexity, and profound consequences, late-life depression warrants focused clinical attention. Timely diagnosis and appropriate management including psychotherapy, pharmacotherapy, and electroconvulsive therapy can significantly reduce morbidity and improve functional outcomes. This review examines the distinctive clinical features, diagnostic challenges, epidemiological context, and therapeutic approaches relevant to depression in the elderly.
Definition of a Major Depressive Episode and Specific Features in Older Adults
The diagnosis of a major depressive episode is clinical and relies on standardized criteria, primarily those outlined in the International Classification of Diseases, 11th Revision (ICD-11), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) [10,11]. Both classifications require core symptoms: persistent low mood and/or anhedonia every day for at least two weeks, leading to significant distress or impairment.
Major depressive episodes, as defined by standard diagnostic criteria, require the presence of at least five symptoms over a two-week period, including either depressed mood or loss of interest or pleasure. Additional symptoms may include significant weight change, sleep disturbances, psychomotor changes, fatigue, feelings of worthlessness or excessive guilt, diminished concentration, and recurrent thoughts of death or suicide. In older adults, it is crucial to recognize that these symptoms may present differently, with somatic complaints or cognitive impairment sometimes overshadowing mood-related indicators. Careful assessment is therefore essential to differentiate depression from medical comorbidities and age-related cognitive decline. Severity is mild, moderate, or severe based on the number, intensity, and impact of symptoms on daily life.
In older adults, however, the clinical presentation often diverges from that seen in younger individuals. Classical affective symptoms such as sadness and guilt may be less prominent or even absent, contributing to under-recognition. The common assumption that sadness, pessimism, or social withdrawal are normative aspects of aging is erroneous and may delay diagnosis [12].
Depression in the elderly frequently manifests through nonspecific or somatic complaints, including chronic fatigue, cognitive concerns, feelings of loneliness, diffuse physical pain, unexplained weight loss, and gastrointestinal symptoms. Additional warning signs may include refusal of food or medication, neglect of personal hygiene, and increased consumption of alcohol or benzodiazepines (13). Symptom presentations are heterogeneous and may include psychomotor retardation, marked anxiety, or delusional themes related to incurability, harm, or financial ruin. In “masked” depressions, behavioral disturbances irritability, hostility, regression, hypochondriasis—can obscure underlying affective symptoms.
Cognitive impairment is common and may precede, accompany, or follow depressive episodes. These cognitive symptoms are associated with poorer treatment response and worse functional outcomes (13). Depression also co-occurs frequently with neurological disorders such as stroke, Parkinson’s disease, and dementia, making it challenging to distinguish mood-related symptoms from those of neurodegenerative disease.
Cerebrovascular disorders have been associated with cases of depression that begin after the age of 65. Subcortical white matter lesions may disrupt fronto-subcortical circuits involved in mood regulation, contributing to the subtype known as “vascular depression” (16). These patients often present with executive dysfunction and have comorbid cardiovascular risk factors, including hypertension, dyslipidemia, and atrial fibrillation [17]. This neurovascular hypothesis highlights the importance of evaluating underlying medical and neurological conditions in the assessment and management of depressive symptoms in late life.
Epidemiological Data
Epidemiological findings in late-life depression vary widely due to differences in diagnostic criteria, assessment tools, and study designs [18]. The absence of a universally accepted definition of depression in older adults further complicates prevalence estimates. Evidence also suggests that symptom profiles may differ significantly from those in younger populations, potentially representing clinical subtypes influenced by age-related neurobiological changes.
Depression is consistently underdiagnosed and undertreated in this population, with 60%–70% of cases going unrecognized. The prevalence of major depressive episodes in community-dwelling older adults ranges between 1% and 4%. Broader estimates including minor and subthreshold depression—range from 8% to 16% in individuals aged ≥65, rising to 12%–15% in those over 85 years.
Recent research also highlights the impact of social factors on the development and course of depression in older adults. Social isolation, bereavement, and loss of meaningful roles after retirement can exacerbate vulnerability to depressive episodes. Additionally, cultural attitudes towards mental health and aging may influence whether individuals seek help, potentially contributing to under-recognition and undertreatment. Recognizing these contextual factors is essential for developing comprehensive prevention and intervention strategies tailored to the unique needs of the elderly population.
Rates are significantly higher in institutionalized settings, ranging from 10% to 45%, depending on assessment method. In primary care, 15%–30% of elderly patients present with clinically significant depressive symptoms, yet many remain undiagnosed. Among elderly psychiatric inpatients, prevalence may reach 35% [19].
Semiology of Depression in Older Adults
Although core depressive symptoms occur across all age groups, their expression in older adults is often atypical or muted. Somatic complaints frequently predominate and may obscure the underlying mood disorder [20]. Older adults may report low mood; however, anhedonia is often the more reliable diagnostic marker. Additional affective symptoms include pervasive fatigue, apathy, hopelessness, self-directed anger, and pessimism. Although a reduction in interests may be a normal aspect of aging, diminished enjoyment in fundamental activities such as eating warrants assessment for potential depression (21). Psychomotor retardation is common but can be difficult to assess because of age-related mobility limitations. Patients frequently report difficulties with concentration, slowed thinking, and altered perception of time. Somatic symptoms gastrointestinal complaints, musculoskeletal pain, cardiovascular symptoms, headaches are highly prevalent (22). Fatigue is one of the most disabling symptoms. Hypochondriacal concerns often focus on cardiovascular, urinary, or gastrointestinal systems and may become delusional in severe cases, such as Cotard’s syndrome (23).
Cognitive disturbances frequently accompany depressive symptoms and complicated differentiation from early dementia (24). Depression impairs attention, encoding, retrieval, and explicit memory, whereas implicit memory typically remains preserved. Unlike patients with Alzheimer’s disease, who often lack awareness of deficits, depressed patients may express deep concern about memory decline (25).
Sleep disturbances and anxiety are common. Anxiety is often severe, pervasive, and without clear external triggers. Behavioral manifestations restlessness, moaning, irritability, aggression—may be distressing for caregivers (26). Additional presentations include phobic symptoms, functional neurological symptoms (conversion), food refusal, social withdrawal, mutism, and substance misuse (27).
Suicidal ideation is common but frequently overlooked. Older adults have a suicide rate more than twice that of the general population, with the highest rates among men over 85 years [28]. Clinicians must systematically inquire about suicidal thoughts.
Although reductions in libido are common with age, a sudden decline in sexual interest should prompt evaluation for depression [29].
Diagnostic Challenges in Late-Life Depression
Furthermore, the diagnostic process is complicated by the tendency for both patients and health professionals to attribute depressive symptoms to physical illness or normal aging, rather than recognizing them as a distinct mental health disorder. This misattribution can delay appropriate intervention and exacerbate the severity of depression. The lack of standardized screening protocols in many healthcare settings also contributes to underdiagnosis, as subtle presentations may be missed during routine assessments. Late-life depression is frequently underdiagnosed and insufficiently treated [30]. Approximately 80% of initial presentations occur in primary care settings, yet only 4%–14% of older adults with depressive symptoms receive a formal diagnosis, despite 15%–30% presenting with clinically relevant symptoms [31].
A key barrier is the persistent misconception that depression is a normal part of aging [32]. Additional diagnostic challenges include:
-High prevalence of somatic comorbidities with overlapping symptoms (fatigue, anorexia, sleep disturbances, psychomotor slowing)
-Adverse effects of polypharmacy mimicking depressive symptoms [33]
-Cognitive impairment limiting communication
-Atypical symptom presentation
-Stigma reducing disclosure of emotional distress
Clinicians must maintain a high index of suspicion when somatic or affective complaints appear disproportionate to situational stressors or when treatment responses are inadequate. Early detection and intervention are crucial to reducing morbidity, functional decline, and mortality [34].
Depression and Dementia: Diagnostic and Clinical Interactions
Distinguishing between depression and dementia in older adults is particularly challenging [35]. Late-life depression is increasingly recognized as both a risk factor for dementia and a prodromal symptom, especially for Alzheimer’s disease and vascular dementia [36]. Conversely, depressive symptoms are common in various dementia syndromes, including Parkinson’s disease dementia, dementia with Lewy bodies, frontotemporal dementia, and Alzheimer’s disease [37].
Shared neuroanatomical substrates, including disruptions in fronto-subcortical circuits, cerebral atrophy, periventricular ischemia, and white matter lesions, contribute to overlapping clinical features [38].
Patients with dementia typically show executive and short-term memory deficits, often accompanied by anosognosia. Patients experience intermittent mood changes but still find pleasure in activities. Antidepressants do not improve cognitive function in these cases (39).
Accurate differentiation between depressive and dementing disorders is crucial for guiding treatment and prognosis. Clinicians should pay close attention to symptom chronology, the presence of neurovegetative signs, and response to therapeutic interventions. Collaboration with caregivers and informants often clarifies subtle cognitive or mood changes, aiding diagnosis.
Depressive pseudodementia is a condition caused by depression that leads to significant problems with cognition, such as difficulties in paying attention and concentrating. These symptoms set it apart from other types of cognitive impairment. Symptoms such as low mood (often worse in the morning), anhedonia, sleep disruption, and appetite changes are common. Cognitive impairment typically improves with antidepressant treatment, helping differentiate it from neurodegenerative disorders (40).
Longitudinal follow-up and comprehensive neuropsychological assessment are often necessary to establish an accurate diagnosis.
Vascular Depression
Forty years ago, post-stroke depression was considered the only true form of depression in older adults. The concept of vascular depression has since gained acceptance as a distinct subtype arising within two years of a cerebrovascular event or in association with chronic ischemic lesions.
Lesions in the left prefrontal cortex and other regions involved in mood regulation are associated with increased prevalence and greater severity of depression, as well as poorer response to conventional antidepressants [43]. Chronic vascular lesions often correlate with psychomotor retardation, anhedonia, and functional decline, with fewer psychotic features or guilt-related themes.
Frontal lobe involvement frequently leads to dysexecutive syndrome characterized by impaired planning, problem-solving, and cognitive flexibility accompanied by marked apathy and psychomotor slowing, with less overt sadness [44].
Suicide Risk
Suicide is the ninth leading cause of death among individuals aged 65–84. Although older adults attempt suicide less frequently than younger individuals, the lethality of attempts is markedly higher, with a completion ratio of approximately 4:1 compared to 200:1 in individuals under 25 [45].
Elderly men, especially those over eighty-five, exhibit the highest suicide mortality rates, partly due to the use of more lethal methods. Approximately 75% of suicide deaths occur during the first depressive episode, and 60% of individuals have seen a healthcare professional within the month prior to suicide [46].
Risk factors include insomnia, hopelessness, agitation, psychosis, alcohol use, chronic pain, terminal illness, social isolation, and previous suicide attempts[48]. Neurobiological changes in the aging brain, particularly prefrontal cortex alterations, may increase vulnerability [47].
Early detection and initiative-taking management of depression are essential to reducing suicide-related mortality.
Treatments for Depression in the Elderly
Management of late-life depression requires a multimodal approach involving psychotherapy, pharmacotherapy, and electroconvulsive therapy (ECT) [49]. Treatment selection depends on symptom severity, comorbidities, access to care, and patient preference.
Psychotherapy
Psychotherapy is the preferred first-line treatment for mild to moderate depression in older adults. Mobility limitations and logistical challenges may impede access. Psychotherapeutic interventions aim to reduce symptoms, improve lifestyle, and decrease social isolation. Physical activity has also shown antidepressant benefits [50].
Combined psychotherapy and pharmacotherapy produce superior outcomes compared to monotherapy [51].
Pharmacological Treatments
Pharmacotherapy in older adults requires careful dosing because of age-related changes in pharmacokinetics and pharmacodynamics, including reduced renal and hepatic function, altered drug distribution, and polypharmacy interactions [52]. Monotherapy with short half-life agents is preferred.
Antidepressants:
Efficacy is like that seen in younger adults, but results may be less favorable if dosing is too low or treatment duration is insufficient [53]. The starting dose should be reduced by half and then increased
gradually. If no improvement occurs after four weeks, switching agents may be appropriate. Treatment should continue for at least 12 months after remission [54].
SSRIs:
First-line agents. Avoid fluoxetine (long half-life) and paroxetine (anticholinergic effects). Sertraline is often preferred. Monitor for hyponatremia, akathisia, parkinsonism, and bradycardia (55–57).
SNRIs:
Second-line agents (duloxetine, venlafaxine). Avoid uncontrolled hypertension or arrhythmias. Duloxetine is advantageous in comorbid neuropathic pain [58].
Tricyclic antidepressants (TCAs):
Reserved for resistant cases. Effective but limited by anticholinergic and cardiovascular risks [59].
Atypical antidepressants:
Mirtazapine is useful when sedation or weight gain is desired [60]. Bupropion can help with apathy and slow movement, and people with Parkinson's disease generally tolerate it well [61].
Augmentation strategies:
Atypical antipsychotics (aripiprazole, quetiapine, risperidone) may potentiate antidepressant effects [62]. Other augmentation options include olanzapine–fluoxetine combinations, thyroid hormones, lithium, and pramipexole [63,64].
Esketamine:
Effective for treatment-resistant depression, with similar outcomes in adults ≥65 years. Start at 28 mg and titrate to 84 mg. Contraindicated in recent cardiovascular events or cerebrovascular disease [66].
Depression in dementia:
While antidepressants may offer benefits, tricyclic antidepressants (TCAs) should be avoided because of their anticholinergic side effects. Despite available treatments, antidepressant efficacy in the elderly remains insufficiently documented, as few controlled trials include older adults [67,68]. A large proportion of cases are treated as treatment-resistant depression [69].
Selecting medications to treat depression in individuals with dementia should consider their cognitive abilities, existing health issues, and side effects. SSRIs, or selective serotonin reuptake inhibitors, are commonly prescribed since they usually have fewer side effects. However, it is important to monitor patients closely to prevent issues such as hyponatremia and falls. If depression is very serious or doesn't improve with first-line treatments, other drugs such as mirtazapine or bupropion might be considered. It is essential to keep track of how these drugs affect appetite, sleep patterns, and physical movement.
Non-pharmacologic interventions, such as structured psychotherapy and caregiver support, play a pivotal role in managing depression in patients with dementia. Approaches like cognitive-behavioral therapy, reminiscence therapy, and environmental modifications can reduce depressive symptoms and improve quality of life. It is crucial to involve family members and caregivers in the treatment plan, as their support can enhance adherence and facilitate early recognition of symptom changes.
Electroconvulsive Therapy (ECT)
ECT is highly effective in late-life depression, with higher remission rates than in younger adults. This approach is recommended for individuals experiencing severe, psychotic, or treatment-resistant depression, and when medication cannot be tolerated. ECT is safe even in individuals over eighty-five and those with cerebrovascular comorbidities. Maintenance ECT reduces relapse rates and avoids complications of polypharmacy (71).
Depression in older adults is common, often presents atypically, and leads to increased morbidity, functional decline, and mortality. Despite its prevalence in primary and geriatric care, late-life depression is frequently overlooked and undertreated. The findings of this review highlight the complex and multifactorial nature of depression in the elderly, encompassing biological, psychological, and social determinants.
One of the principal challenges identified is the atypical symptomatology in older adults. Compared with younger populations, depressive episodes in later life are more likely to present with somatic complaints, cognitive impairment, psychomotor retardation, and anxiety, while sadness, guilt, or overt dysphoria may be less prominent. These differences contribute to diagnostic delays and misattribution of symptoms to normal aging or chronic medical conditions. Furthermore, cognitive symptoms complicate the distinction between depression, mild cognitive impairment, and early dementia. Increasing evidence supports the notion that late-life depression, particularly late-onset forms, is both a risk factor for and a prodrome of neurodegenerative disorders. Recognizing this bidirectional relationship is essential for both early intervention and longitudinal monitoring.
Another important theme emerging from literature is the role of vascular pathology in geriatric depression. The “vascular depression” hypothesis, supported by neuroimaging and clinical data, links cerebrovascular lesions particularly within frontostriatal circuits to depressive syndromes characterized by apathy, executive dysfunction, and reduced response to traditional antidepressants. This underscores the need for integrated management strategies that address both psychiatric and cardiovascular risk factors, including hypertension, diabetes, dyslipidemia, and atrial fibrillation.
Suicide risk remains a critical concern in this population. Older adults have the highest suicide completion rates of any age group, particularly men over 85. Disproportionate lethal methods, severe medical comorbidities, social isolation, and reduced help-seeking behaviors all contribute to this elevated risk. The fact that most older adults who die by suicide have had recent contact with healthcare services highlights the urgent need for improved screening, early diagnosis, and initiative-taking intervention.
Managing depression in older adults requires a personalized approach that considers changes in their bodies due to aging, multiple medications they may be taking, and other existing health issues. Psychotherapy remains a first-line intervention for mild to moderate depression, but access barriers including mobility limitations, sensory deficits, and caregiver dependence often reduce uptake. Pharmacotherapy is effective but requires careful dosing, slow titration, and vigilant monitoring for adverse effects such as hyponatremia, orthostatic hypotension, and cardiac conduction abnormalities. Selective serotonin reuptake inhibitors remain the preferred option, although alternative classes such as serotonin-norepinephrine reuptake inhibitors, mirtazapine, and bupropion may be appropriate depending on clinical features. In cases of treatment-resistant depression, augmentation strategies and newer therapies such as esketamine offer promising alternatives, although evidence in older adults remains limited.
Electroconvulsive therapy continues to demonstrate robust efficacy and safety in older populations. Unlike in younger adults, age is not a limiting factor and may even predict better treatment response. ECT is recommended early when patients have psychotic depression, are at elevated risk of suicide, experience significant impairment in daily functioning, or cannot tolerate medication.
Overall, the literature emphasizes the importance of a comprehensive, multidisciplinary approach to the diagnosis and management of depression in older adults. The integration of medical, psychiatric, cognitive, and social assessments is key to improving outcomes. Future research should prioritize well-designed clinical trials involving older participants, particularly those with medical comorbidities and cognitive impairment, who remain underrepresented in current evidence. A better understanding of the neurobiological underpinnings of late-life depression, especially vascular and neurodegenerative mechanisms, may guide the development of more targeted and effective therapies.
Depression in older adults is a prevalent, complex, and often underdiagnosed condition that significantly affects quality of life, functional capacity, and mortality. Its atypical clinical presentation, frequent overlap with cognitive impairment, and high burden of medical comorbidities make early recognition particularly challenging. Effective management requires a comprehensive and individualized approach that integrates psychosocial, medical, and pharmacological strategies. Psychotherapy, appropriately selected antidepressants, and electroconvulsive therapy each play important roles, although treatment must be tailored to age-related physiological changes and the risks associated with polypharmacy. Additionally, addressing the stigma associated with mental health issues in older adults remains crucial. Many individuals may hesitate to seek help due to fear of being judged or concerns about burdening their families. Educational initiatives targeting both healthcare professionals and the public can help foster a more supportive environment, encouraging timely identification and treatment of depressive symptoms. Obstacles to achieving optimal care go beyond clinical or biological reasons; they also involve stigma, low levels of mental health literacy, and a lack of adequate training for healthcare professionals in identifying depression among older adults. Additionally, disparities in access to specialized geriatric mental health service particularly in rural or underserved areas further hinder timely identification and treatment.
In summary, depression in older adults is a multifaceted condition that demands vigilant recognition and tailored interventions. Timely identification, thorough assessment of contributing factors, and an individualized treatment plan encompassing both pharmacological and non-pharmacological strategies are crucial in reducing disease burden and improving quality of life. Collaboration among primary care, psychiatry, neurology, and social services remains essential to address the unique challenges faced by this population. Ongoing education for clinicians and caregivers, along with enhanced access to mental health resources, will further support successful management and recovery in late-life depression.
Addressing these systemic issues is crucial for improving detection rates and ensuring equitable mental health support for older adults. Collaborative care models, which incorporate mental health specialists into primary care settings, have demonstrated effectiveness in improving outcomes for older adults with depression. Greater awareness among healthcare providers, systematic screening, and improved access
to geriatric mental health services are essential to reducing the substantial burden of late-life depression. Future research should focus on better characterizing its neurobiological mechanisms, refining diagnostic tools, and expanding evidence-based treatment options specifically validated in older populations.
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Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
Dear Grace Pierce, Editorial Coordinator of the journal IJCCR, I had a very positive experience with Auctores - Journal throughout the publication process. The Editorial Team was highly responsive, professional, and supportive at every stage. I would like to extend my sincere thanks to the Editor: Grace Pierce, for her guidance and assistance. The peer-review process was smooth and constructive, helping improve the quality of my work. I would gladly recommend Auctores Journal to fellow researchers and authors. Dr. SABITA SINHA, Medical Oncologist, MD (Electro Homeopathy).
Dear Maria Emerson, Editorial Coordinator of - Journal of Clinical Research and Reports. ''I am pleased to provide this testimonial following the publication of our recent case report in this journal. The peer review process was rigorous, constructive, thorough, and conducted in a timely manner. The reviewers’ comments were thoughtful, detailed, and highly constructive, contributing substantially to the refinement, clarity, and scientific robustness of our manuscript. The process was conducted with professionalism and academic integrity throughout. The support provided by the editorial office was exemplary. Communication was consistently prompt, clear, and courteous at all stages of the submission and publication process. The editorial team demonstrated a high level of organization and responsiveness, ensuring that all queries were addressed efficiently and that the process remained transparent and well-coordinated. The overall quality of the journal is reflected in its strong editorial standards, commitment to scientific excellence, and dedication to publishing clinically meaningful research. It has been a privilege to publish our work in this journal, and we would welcome the opportunity to contribute further in the future.'' Best wishes from, Dr. Efstratios Trogkanis, Cardiologist.
Dear Reader: We have published several articles in the Auctores Publishing, LLC, journal, Clinical Medical Reviews and Reports in recent years (CMRR). This is an ‘open access’ journal and the following are our observations. From the initial invitation to submit an article, to the final edits of galley proofs, we have found CMRR personnel to be professional, responsive, rapid and thorough. This entire process begins with Catherine Mitchell, Editorial Coordinator. She is simply outstanding, and, I believe, unparalleled in her capacity. I cannot imagine a more responsive and dedicated Editorial Coordinator. As I read the dates and timing of her correspondence with us, it seems that she never sleeps. I hope Auctores Publishing, LLC, appreciates her efforts as much as these authors do. Thank you to Auctores Publishing, LLC, to the Editorial Staff/Board, and to Catherine Mitchell from a grateful author(s).
