By James M. Ellison, Helen H. Kyomen, Sumer Verma
Temper issues in Later existence examines the spectrum of temper problems in older adults, targeting significant and nonmajor depressive problems, bipolar sickness (manic and depressive phases), melancholy with psychotic positive factors, and vascular melancholy. intensive discussions of analysis and remedies together with psychotherapy, pharmacotherapy, and ECT may help clinicians enhance remedy results of their aged sufferers. This moment variation, an replace and growth of the 2003 melancholy in Later lifestyles, contains many extra themes together with dialogue of the epidemiology of past due lifestyles temper issues, the prognosis and remedy of overdue existence bipolar illness, use of non-ECT neurotherapeutic techniques, and the significance of open entry to the entire variety of remedies. This complete, single-source reference is perfect for all psychiatrists, neurologists, and first care physicians and complex perform nurses treating older adults. extra issues contain: overcoming limitations to therapy cross-cultural concerns the neurobiology of past due existence temper issues scientific comorbidity drug interactions prevention of later lifestyles suicide upkeep remedies
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Extra resources for Mood Disorders in Later Life, Second Edition (Medical Psychiatry Series)
Sample text
Minor depression was associated with a significantly greater decline in functional status and performance, as well as with increased risk of death in men. Major depression increased risk of functional decline and death in men and women When present for at least 6 years, depression was associated with a generally increased risk of cancer, after controlling for age, sex, race, disability, hospital admissions, alcohol intake, and smoking Normalized prefrontal lobe volumes show a significant linear trend with severity of depression, with volumes decreasing with volume severity Geriatric Nonmajor Depressive Syndromes 21 16 weeks of randomized trial of sertraline, exercise, or usual care Meta-analysis of 89 studies of depressive disorders 138 elderly minor depression 6-week open-label study of sertraline treatment of minor depression (87) (77) (82) (17) Interventions Cross-sectional sample of minor- and major depressed patients and nondepressed volunteers Family study (60) (86) Study design Authors Cognition Area of research Subjects received citalopram 20mg/day (66) or sertraline 50mg/day (72) for 1 year.
Int J Psychiatry Med 1996; 26:177–209. 47. Unutzer J, Patrick DL, Simon G, et al. Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA 1997; 277:1618–1623. 48. Barrett JE, Williams JW, Oxman TE, et al. The treatment effectiveness project. A comparison of the effectiveness of paroxetine, problem-solving therapy, and placebo in the treatment of minor depression and dysthymia in primary care patients: Background and research plan.
Like major depressive disorder, these conditions contribute substantially to functional impairment and morbidity (6), yet the criteria for major depressive disorder outlined in the DSM-III and DSM-IV TR do not capture less severe symptomatology in depressed elders (8) and the presence of nonmajor depressive states often goes undetected. Blazer (10) observed that elderly patients rarely report depressed mood despite appearing to be depressed as determined by the presence of other depressive symptoms and measurable outcomes.