Geriatric Psychiatry

Three studies over the past three years show that individuals over age 65 who are suffering from depression may still not be receiving the treatment they need. Is integrating treatment into primary care the answer?

Monitoring patients for possible QTC prolongation with psychotropic use can be difficult--even more so in children or adolescents. What screening and treatment techniques should be used for maximum therapeutic benefit with minimum cardiac risk?

Psychopharmacologic management has become increasingly complex, and physicians run the risk of precipitating drug-drug interactions when certain drugs interact via the cytochrome P450 system. In addition, the P-glycoprotein transporter may play a role in certain drug-drug interactions. While physicians currently rely on Web sites and textbooks to avoid potentially morbid and lethal interactions, electronic medical records may play a crucial role in the future.

In modern practice, psychiatrists will invariably have patients who come from different ethnic or cultural backgrounds. Practitioners will need to consider socioeconomic status, diet, use of herbal medications and immigration status, as well as patients' own self-perception of ethnicity, in assessing patients and planning treatment.

With proposed cuts in state budgets nationwide, social services--including mental health care--are taking a financial blow. As a result, mental health care facilities are closing and services are disappearing. What will the effect be on patient care?

Depression and dementia or Alzheimer's disease often go together. The presence of dementia may also increase the odds of depression. What can clinicians do to treat these two often comorbid conditions?

Recent studies have shown that patients with schizophrenia experience a greater decline in cognitive abilities with age. Given the large baby boomer population, how will this influence treatment for aging patients with schizophrenia?

Cognitive impairment is a common symptom in many psychiatric and neurologic conditions. The articles selected for this Psychiatric Times special report provide a sampling of some important and topical issues regarding the influence of various factors on cognition in individuals with neuropsychiatric conditions.

What role might cognitive functioning play in suicidal ideation in elderly patients? How can psychiatrists determine the cognitive functioning skills of older patients who express suicidal thoughts?

Euthanasia is a word coined from Greek in the 17th century to refer to an easy, painless, happy death. In modern times, however, it has come to mean a physician's causing a patient's death by injection of a lethal dose of medication. In physician-assisted suicide, the physician prescribes the lethal dose, knowing the patient intends to end their life.

According to a survey done in 1999, 54% of Oregon's psychiatrists and 75% of the state's psychologists supported physician-assisted suicide, whereas between 20% and 33% of all health care professionals opposed it. The debate continues, as the federal government is trying to take away prescribing privileges for physicians who prescribe life-ending medications.

Women with schizophrenia may benefit from hormone replacement therapy. A new study measured the efficacy of estrogen, progesterone, Prolactin, luteinizing hormone, follicle stimulating hormone and testosterone on women with the disorder.

In what ways does culture impact treatments of depression? This case study follows the progress of "Mrs. H," a 77-year-old African-American female.

The current climate of managed care has dramatically changed how psychiatrists deal with the issue of suicide. What should clinicians know, both about the safety and welfare of their patients and to protect themselves legally, when dealing with managed care companies in cases of potential suicidality?

Assessing and treating suicidal behavior in the elderly can be difficult. What are the risk factors and how can this population best be treated?

The American Psychiatric Association has developed a sweeping vision for reforming mental health care in the midst of a fiscal crisis that it says threatens a wholesale collapse of the system. The plan calls for an investment in mental health services equal to the level of disability that mental disorders cause, an end to behavioral health carveouts and better integration between psychiatry and primary care.

Although the prospect of online mental health care raises obvious questions, it also offers an opportunity to make cost effective services available to many who may not otherwise have access. By understanding issues such as confidentiality, emergencies and lack of face-to-face contact, psychiatrists can determine if this area of treatment is right for them.

Inpatient care for the wealthy has arrived--fluffy bath robes, in-room Jacuzzis, a concierge at your beck and call. Do the luxuries of these "resorts" negate the care that is being provided, or can patients have the best of both worlds?

The World Trade Center attack changed the face of the United States and of psychiatry. Men and women of the cloth and of the clinic came together to care for the stricken masses. Yet, members of the clergy do not always refer congregants who exhibit duress to the psychiatrist, nor do psychiatrists refer patients to the clergy. What keeps these two fields apart? What is best for your patient?

Although late-onset psychosis is not as common as the early-onset variety, it can still pose difficulties in diagnosing and treating patients. How are patients with late-onset psychosis different from those who have early-onset, and what sorts of issues should clinicians be aware of?

Groups are important throughout the course of a patient's therapy, especially for patients who have substance use disorders. Group therapy's clinical and cost benefit is evaluated for its efficacy in preventing and treating substance abuse.

New developments in neuroimaging and effective diagnostic tools can help obtain early diagnosis of and timely treatment for Alzheimer's disease.

The promise of natural products as possible sources of new treatments for Alzheimer's disease and other dementing illnesses is on the rise. Scientific evidence for the 13 dietary supplements most commonly used for memory impairment is analyzed and evaluated.

Alzheimer's disease (AD) is a devastating and debilitating neurodegenerative condition, and the most common cause of dementia among the elderly. Despite considerable advances in the cellular and molecular biology of AD, however, little progress has been made in identifying the causes of the disease.

Patients with Alzheimer's disease and psychosis often have a more severe course of illness, with higher incidence of caregiver burden and hospitalization. Differentiating this disorder from Alzheimer's disease uncomplicated by psychosis is key to maximizing more positive outcomes.