Geriatric Psychiatry

A recent symposium brought together some of the nation’s leading experts to talk about promising advances in psychiatry and to address areas where progress has faltered.

For patients with treatment-resistant depression-especially geriatric patients-ECT is a viable treatment option . . . one that should no longer be relegated to the option of last resort.

Planck's Law of Generations: scientific change doesn't happen by changing minds, but by changing generations.

Mental rigidity can occur at any age, while wisdom and experience are hard-won--over time.

Drug interactions are more frequent in elderly patients because more medications are taken. In addition, drug interactions may be more serious because of insufficient physiological reserves. When new medications are started or stopped in elderly patients, it is very important to take note of potential interactions with other drugs or foods.

The goal of this article is to improve recognition of comorbid psychiatric and movement disorders and to help the reader formulate a management strategy using a multidisciplinary approach.

Medical colleagues routinely monitor patients with sphygmomanometers, peak flow meters, and glucometers. Similarly, psychiatrists can and should incorporate the use of screening tools to help with diagnosis and treatment management.

It’s comforting to think we control our lives. Then the weathermen predict a meteorologic Armageddon, and this time their predictions turn out to be correct.

Is the expression “mental illness” merely a metaphor? If so, does that tell us something about the persons we identify as having a mental illness? To clinicians who deal with devastating psychiatric disorders every day-and to those afflicted with these conditions-these questions may seem like a lot of semantic nonsense.

Four studies sprang from the TORDIA trial on treatment-resistant depression in children and adolescents and showed that several factors influence treatment efficacy following treatment resistance.

The proposed new diagnostic categories and guidelines for Alzheimer's disease include not only dementia, but also the preclinical and mild cognitive impairment (MCI) phases of AD.

The role of subtyping and bipolarity in TRD was discussed in Part 1 of this 2-part article. Here we review a number of the most common confounding factors of TRD but limit our scope to comorbidities that can be directly addressed and treated by psychiatrists.

Two recent publications provide clinically relevant information about the risk to benefit ratio of antidepressants for the treatment of MDD in youths, adults, and the elderly.

Of the 3 informative articles included in this special geriatric collection, 1 offers a perspective on the treatment of depression that does not focus on somatotherapy. The others remind us of 2 additional geriatric Ds of importance: drugs and driving.

This article provides a practical overview of the available evidence-based treatment and discusses circumstances in which certain interventions may be preferred over others.

As we are faced with a growing population of older adults, a better understanding of the issues that they confront is crucial.

Medical professionals may be reluctant to initiate a discussion about driving with older patients in anticipation of a negative impact on the physician-patient relationship.

New diagnostic guidelines and advanced screening tools enable clinicians to detect dementia and Alzheimer disease earlier than ever.

Age is a major risk factor for the development of Alzheimer disease and other dementias. New technologies in brain imaging represent major advances in our ability to diagnose age-related cognitive and behavioral disorders.

The trouble with answering this question is that I couldn’t – and still can’t – recall the “best” memory. What much more readily came to mind are some of the worst memories.

In a recent interview on 60 Minutes, Harvard psychologist Irving Kirsch, PhD, commented, “the difference between the effect of a placebo and the effect of an antidepressant is minimal for most people.”

This elderly man no longer has decision-making capacity. What legal resource does he have?

Educated and successful individuals, Mr H's children seem able to understand that their father can no longer make his own decisions, but they continue to defer to him for medical and disposition decisions stating, “whatever he wants to do.”

Psychiatrists cannot, with impunity, disregard an important domain of man’s personality makeup. He ought to remain a searcher of the soul at large.

Although the adverse-effect profile of older, conventional (typical) antipsychotics has discouraged many clinicians from using them, they remain widely used in elderly patients with dementia.