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Geriatric bipolar

Victoria Williamson, Sharon A M Stevelink, Karla Greenberg, Neil Greenberg
OBJECTIVE: Older veterans may be vulnerable to mental health problems. Meta-analytic and systematic review methods sought to determine the prevalence rate of mental health disorders in older military veterans (≥65 years). METHODS: Eleven studies were eligible, and meta-analyses of veteran depression, substance abuse, post-traumatic stress disorder (PTSD), anxiety, dementia, bipolar disorder, and schizophrenia were conducted. RESULTS: Although conducted exclusively with U...
November 8, 2017: American Journal of Geriatric Psychiatry
B S Suganya Priyadharshini, I Syed Ummar
Objectives: Objective in our study is i) To assess the prevalence and sociodemographic profile of cutaneous side effects in bipolar affective disorder patients (BPAD) on lithium. ii) To assess the course of pre-existing skin reactions, when patient is initiated on lithium therapy. Methods: Lithium induced cutaneous side effects were assessed at baseline and monthly for 6 months followed by every 2 months over a year. Dermatologist opinion obtained to diagnose and treat for each patient who developed cutaneous side effects...
September 2017: Indian Journal of Psychological Medicine
Liana K Mathias, Patrick J Monette, David G Harper, Brent P Forester
The prevalence of mood disorders in the rapidly-growing older adult population merits attention due to the likelihood of increased medical comorbidities, risk of hospitalization or institutionalization, and strains placed on caregivers and healthcare providers. Magnetic resonance spectroscopy (MRS) quantifies biochemical compounds in vivo, and has been used specifically for analyses of neural metabolism and bioenergetics in older adults with mood disorders, usually via proton or phosphorous spectroscopy. While yet to be clinically implemented, data gathered from research subjects may help indicate potential biomarkers of disease state or trait or putative drug targets...
December 2017: International Review of Psychiatry
Jakub Szpunar, Hitoshi Maeshima, George T Grossberg
BACKGROUND: Lithium is a first-line treatment for bipolar disorder in geriatric patients; however, it has long been associated with potentially significant renal consequences, including chronic kidney disease (CKD). METHODS: We reviewed the available evidence to characterize the effects of lithium on renal function, provide a consensus on periodic monitoring, and propose criteria for transitioning an older patient with bipolar disorder and renal issues to an alternate medication...
November 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
Rene Tavernier, Michael Wolf, Vikas Kataria, Tom Phlips, Ruben Huys, Philippe Taghji, Ruan Louw, Raf Van Hoeyweghen, Yves Vandekerckhove, Sébastien Knecht, Mattias Duytschaever
OBJECTIVES: To assess whether daily short-term rhythm strip recordings on top of routine clinical care could increase the atrial fibrillation (AF) detection rate in the hospitalised elderly. METHODS: A hand-held device storing a bipolar ECG during 1 min was used for daily rhythm recording in hospitalised elderly patients. RESULTS: During 2 months, all patients admitted to the Department of Geriatric Medicine were screened (n=327). Five patients refused to participate in the study and 70 patients were unable to hold the device due to severe mental (n=46) or motor impairment (n=24)...
April 2018: Heart: Official Journal of the British Cardiac Society
Norm O'Rourke, Marnin J Heisel, Sarah L Canham, Andrew Sixsmith, Hamed Yaghoubi-Shahir, David B King
OBJECTIVES: Across age groups, bipolar disorder (BD) carries the greatest risk of death by suicide of all psychiatric conditions; 25%-50% of those with BD will make one or more suicide attempt. Psychometrically sound instruments are required to reliably measure suicide ideation and risk of self-harm for older adults with BD. For this study, we validate the geriatric suicide ideation scale (GSIS) with adults 50+ years with BD. METHODS: We recruited a global sample of 220 older adults with BD (M = 58...
April 24, 2017: Aging & Mental Health
Pasquale De Fazio, Raffaele Gaetano, Mariarita Caroleo, Maria Pavia, Giovanbattista De Sarro, Andrea Fagiolini, Cristina Segura-Garcia
The prevalence of mania among >65-year-olds ranges from 0.1% to 0.4% and its treatment is a particular challenge for clinicians. Although lithium is the treatment of choice for bipolar disorder (BD), its use in elderly population was recently questioned. This study provides a comprehensive review of literature on the efficacy and tolerability of lithium as a pharmacologic treatment for mania in elderly BD patients. We conducted a systematic review, based on PRISMA guidelines, of articles published between 1970 and August 2016 and indexed in the following databases: EMBASE, MEDLINE, Cochrane Library Databases and PsycINFO...
2017: Neuropsychiatric Disease and Treatment
Hua Zhang, Zhongwei Xu, Aiguo Zhou, Wenlong Yan, Pei Zhao, Xiao Huang, Jian Zhang
The aim of this study was to evaluate the efficacy of supplementary fixation in hip arthroplasty with the use of Kirschner-wires and tension band for geriatric patients suffering unstable intertrochanteric osteoporotic fractures. A total of 103 patients aged more than 75 years were recruited. A bipolar or total hip replacement was performed with additional application of Kirschner-wires and tension band, and the participants were followed up for 2 to 11 years. Physical component summary (PCS), mental component summary (MCS), visual analog scale (VAS), and Harris hip score were utilized to evaluate patients' hip pain and function, as well as the mental condition postoperatively after 1...
January 2017: Medicine (Baltimore)
Andrew W Bodrogi, Robert Sciortino, David A Fitch, Wade Gofton
BACKGROUND: Femoral neck fractures are common injuries in the geriatric population associated with high morbidity and mortality rates. Studies have shown outcomes can be positively influenced by early postoperative mobilization. The supercapsular percutaneously assisted total hip (SuperPath) surgical technique has been shown to lead to early mobilization for osteoarthritic total hip replacement patients and as such has the potential to provide similar benefits in fracture patients. This manuscript provides a detailed description of this technique using hemiarthroplasty to treat femoral neck fractures and presents the first case series of this application...
October 12, 2016: Journal of Orthopaedic Surgery and Research
Leandro da Costa Lane Valiengo, Florindo Stella, Orestes Vicente Forlenza
Despite the lower prevalence of severe mood disorders in the elderly as compared to younger adults, late-life depression and bipolar disorder (BD) are more strongly associated with negative outcomes related to the presence of medical comorbidities, cognitive deficits, and increased suicide risk and overall mortality. The mechanisms that contribute to these associations are probably multifactorial, involving pathological factors related directly and indirectly to the disease itself, ranging from biological to psychosocial factors...
2016: Neuropsychiatric Disease and Treatment
Adriana P Hermida, A Umair Janjua, Oliver M Glass, Camille P Vaughan, Felicia Goldstein, Lynn Marie Trotti, Stewart A Factor
Lithium is a mood stabilizer rarely associated with drug-induced parkinsonism (DIP). We present a case of an elderly woman with bipolar disorder who developed parkinsonian symptoms after chronic lithium administration despite therapeutic serum levels. Upon evaluation, classic parkinsonian signs of muscle rigidity, tremor, bradykinesia, freezing of gait, and cognitive decline were observed. Initially, she was diagnosed with Parkinson's disease (PD); however, DaTscan SPECT imaging clarified the diagnosis as DIP...
December 2016: International Psychogeriatrics
Anjana Sahu, Indirani H Kumar
A 70-year-old female patient, known case of hypertension and incomplete Left bundle branch block (LBBB), posted for bipolar hemiarthroplasty. A geriatric patient with LBBB and systemic hypertension is a fatal combination; it may precipitate into complete AV dissociation during anaesthesia and surgical stress. We are reporting this interesting case as our patient had developed complete Atrioventricular (AV) dissociation when scheduled earlier for surgery and got postponed. We had given combined spinal epidural anaesthesia and managed successfully without any complication...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Annemiek Dols, Lars Vedel Kessing, Sergio A Strejilevich, Soham Rej, Shang-Ying Tsai, Ariel G Gildengers, Osvaldo P Almeida, Kenneth I Shulman, Martha Sajatovic
OBJECTIVE: Older adults with bipolar disorder (OABD) are a growing segment of patients with bipolar disorder (BD) for which specific guidelines are warranted. Although, OABD are frequently excluded from randomized controlled trials due to their age or somatic comorbidity, more treatment data from a variety of sources have become available in recent years. It is expected that at least some of this emerging information on OABD would be incorporated into treatment guidelines available to clinicians around the world...
December 2016: International Journal of Geriatric Psychiatry
Aline T Soares, Ana C Andreazza, Soham Rej, Tarek K Rajji, Ariel G Gildengers, Beny Lafer, L Trevor Young, Benoit H Mulsant
OBJECTIVES: Decreased levels of brain derived neurotrophic factor (BDNF) have been found in adult patients with bipolar disorder (BD) compared with a comparison group, yet there are no data specifically examining this in geriatric patients. The objective of this study was to examine whether euthymic late-life BD patients have lower BDNF levels than healthy comparators. DESIGN: Cross-sectional study. SETTING: Clinics at the University of Pittsburgh and the Centre for Addiction and Mental Health (Toronto)...
August 2016: American Journal of Geriatric Psychiatry
Ching Yu, Jean-Daniel Sylvestre, Marilyn Segal, Karl J Looper, Soham Rej
OBJECTIVE: Many patients with severe recurrent mental illness are approaching late life; however, little is known about psychiatric re-hospitalization in this population. Our objective was to identify predictors of psychiatric re-hospitalization. METHODS: This was a retrospective cohort study of all 226 geriatric patients (age ≥65 years) admitted to a tertiary care Canadian inpatient psychiatric unit between 2003 and 2008. The main outcome was psychiatric re-hospitalization in 5-year follow-up post-discharge (e...
November 2015: International Journal of Geriatric Psychiatry
Martha Sajatovic, Sergio A Strejilevich, Ariel G Gildengers, Annemiek Dols, Rayan K Al Jurdi, Brent P Forester, Lars Vedel Kessing, John Beyer, Facundo Manes, Soham Rej, Adriane R Rosa, Sigfried Ntm Schouws, Shang-Ying Tsai, Robert C Young, Kenneth I Shulman
OBJECTIVES: In the coming generation, older adults with bipolar disorder (BD) will increase in absolute numbers as well as proportion of the general population. This is the first report of the International Society for Bipolar Disorder (ISBD) Task Force on Older-Age Bipolar Disorder (OABD). METHODS: This task force report addresses the unique aspects of OABD including epidemiology and clinical features, neuropathology and biomarkers, physical health, cognition, and care approaches...
November 2015: Bipolar Disorders
Perminder S Sachdev, Adith Mohan, Lauren Taylor, Dilip V Jeste
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Assess the changes in DSM-5 relative to earlier versions.• Evaluate the implications of the DSM-5 for practicing geriatric psychiatrists. ABSTRACT: About every 20 years, the American Psychiatric Association revises its official classification of mental disorders. The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, prompting considerable commentary, debate, and criticism...
September 2015: Harvard Review of Psychiatry
Tor Magne Bjølseth, Knut Engedal, Jūratė Šaltytė Benth, Gro Strømnes Dybedal, Torfinn Lødøen Gaarden, Lars Tanum
BACKGROUND: No prior study has investigated whether impairment of specific cognitive functions at baseline may predict the short-term treatment outcome of electroconvulsive therapy (ECT) in elderly non-demented patients with major depression (MD). METHODS: This longitudinal cohort study included 65 elderly patients with unipolar or bipolar MD, aged 60-85 years, treated with formula-based ECT. Treatment outcome was assessed using the 17-item Hamilton Rating Scale for Depression (HRSD17)...
October 1, 2015: Journal of Affective Disorders
Igor Aedo, Jaime Santander, Christian Weiss, Ximena Fuentes
INTRODUCTION: It is estimated that Chilean geriatric population (=65 years) will hit 16% in the year 2030. Psychiatric longer stays have been described for those equal 65 years vs. less than 65 years. We aim to describe the characteristics associated with lengths of stay in our psychiatric unit. MATERIAL AND METHODS: Retrospective review of 3112 admissions between July 2001 and June 2010 to the general psychiatric service of the Pontific Catholic University of Chile...
November 2014: Vertex: Revista Argentina de Psiquiatriá
Young Sup Woo, Jung Goo Lee, Jong-Hyun Jeong, Moon-Doo Kim, Inki Sohn, Se-Hoon Shim, Duk-In Jon, Jeong Seok Seo, Young-Chul Shin, Kyung Joon Min, Bo-Hyun Yoon, Won-Myong Bahk
OBJECTIVE: To constitute the third revision of the guidelines for the treatment of bipolar disorder issued by the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP 2014). METHODS: A 56-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for the various phases of bipolar disorder and for special populations. The review committee included 110 Korean psychiatrists and 38 experts for child and adolescent psychiatry...
2015: Neuropsychiatric Disease and Treatment
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