Geropsychiatry

INTRODUCTION: The rising proportion of the elderly is increasingly affected by non-communicable diseases. Despite an abundance of literature suggesting that elders with medical conditions are more vulnerable to depression, disability, and cognitive impairment, these tend to go unnoticed and unaddressed. This study describes the prevalence and correlates of depression, disability, and cognitive impairment among elders with medical illnesses attending follow-up clinics in a tertiary care hospital in northern Sri Lanka...

Preliminarily findings from experimental and survey research suggests that psychotherapy with older adults is an area of practice in which psychotherapists do not feel positive and confident. This qualitative study is the first to explore how young psychotherapists experience and perceive their therapeutic work with older patients. To do so, we provide an in-depth perspective of how young (aged 27-35) psychotherapists experience providing psychotherapeutic treatment for older patients (aged over 65). Semistructured interviews were conducted with 20 psychotherapists in training (14 women, six men)...

Elderly persons can get involved in the criminal justice system as victims or as perpetrators. The interaction of elderly persons with mental illness at various cross-sections of the judicial process needs thoughtful consideration. Through this review, the authors approach this less studied aspect of forensic psychiatry. Concerning the evaluation of a prisoner, three scenarios need focused consideration: evaluation for fitness to stand trial before a competent court, evaluations for an insanity defense, and fitness for sentencing...

BACKGROUND: Rising population of elder people and associated rise in health problems, frailty and disabilities have significant socioeconomic and health care implications. Mental health related disability contributes significantly in the global disability statistics and is an important health and quality of life indicator. Assessment of disabilities in elderly is essential part of routine evaluation, further it also helps the clinicians in identifying current functional status and choosing and monitoring therapeutic interventions and need for social welfare schemes...

The goal of the Aging Matters column is to address important issues related to geropsychiatry and the well-being of older adults. This article offers reflections on columns from the past 15 years and how the aging process has changed in issues related to aging and technology, aging healthfully, end-of-life issues, caregivers for older adults, and growing old in American society. To promote successful aging, we need to hear stories of what it is like to grow old in America. We also need research to better understand the aging process and what is needed for successful aging...

RATIONALE: Ketamine is a novel, rapid-acting antidepressant for treatment refractory depression (TRD); however, clinical durability is poor and treatment response trajectories vary. Little is known about which patient characteristics predict faster or more durable ketamine responses. Ketamine's antidepressant mechanism may involve modulation of glutamatergic signaling and long-term potentiation (LTP); these neuroplasticity pathways are also attenuated with older age. OBJECTIVE: A retrospective analysis examining the impact of patient age on the speed and durability of ketamine's antidepressant effects in 49 veterans receiving serial intravenous ketamine infusions for TRD...

INTRODUCTION: Neuropsychiatric symptoms occur in 30% to 40% of patients living with systemic lupus erythematosus (SLE). Brain imaging may play a pivotal role in determining the etiology as it did for the case presented here. METHODS: A new case of central nervous system (CNS) SLE is presented along with an analysis of 33 comparable cases from the scientific literature. RESULTS: A 70-year-old female with subacute cutaneous lupus presented to a university-based geropsychiatry program after 1 year of benign visual hallucinations and several months of shuffling gait, recurrent falls, and forgetfulness...

OBJECTIVE: The objective for the current study is to examine patient satisfaction with geropsychiatry services provided via video telehealth. METHODS: Participants included community-dwelling older Veterans receiving geriatric psychiatry services via telehealth across regions of the Pacific Northwest and Southwestern United States. Participants completed a paper-based survey examining satisfaction with services following the completion of two medication management visits with a geropsychiatrist...

PURPOSE: Implementation of the SAFE PAIN algorithm for reducing opioid use for chronic pain in older adults is described. SUMMARY: A multidisciplinary team at Sheppard Pratt Health System, the largest private provider of psychiatric care in Maryland, used lean methodology to identify the root causes for noncompliance to evidence-based practices for patients in the geropsychiatry unit treated for osteoarthritis or chronic back pain. The team collaborated to develop a facility-specific treatment algorithm, called SAFE PAIN (Sheppard Pratt Health System Algorithm For Elderly Patient Centered Analgesia Interdisciplinary Nagara), was based on the Center for Disease Control and Prevention's evidence-based recommendations that included nonpharmacologic interventions as a first-line therapy for patients with osteoarthritis or chronic back pain...

A panel of experts drawn from neurology, psychiatry, geropsychiatry, geriatrics, and pharmacy representatives of 3 health plans convened in New York City on July 30, 2016, with the objective of sharing opinions, ideas, and information regarding the optimal management of Parkinson's disease psychosis (PDP). Three key points emerged from the discussion: (1) Because of the nature of Parkinson's disease and PDP, finding appropriate treatment can prove challenging; (2) emerging therapies may present an opportunity for effective disease management; and (3) moving forward, provider and patient education regarding PDP and available treatment options is essential for well-managed symptoms and better quality of life...

OBJECTIVE: This study aimed to investigate the neurobiologic correlates of two distinct clusters of agitation symptoms to identify the unique biologic substrates underlying agitated behaviors. METHODS: Eighty-eight outpatients with mild to moderate Alzheimer disease (AD) were recruited from the VA Greater Los Angeles Healthcare System Geropsychiatry Outpatient Program. A cross-sectional investigation was conducted of the relationship between cerebral glucose metabolism measured via 18 F-fluorodeoxyglucose positron emission tomography and agitated symptoms from the Neuropsychiatric Inventory (NPI) in patients with AD...

Validation of remote video teleconference (VTC)-based procedures for geropsychiatry applications is essential to ensure validity and reliability of diagnostic procedures. The current study demonstrates the similarity of scores obtained from several brief neurocognitive screening measures in an outpatient VA geropsychiatry clinic population when participants were tested in-person and via VTC. Results revealed similar mean scores and moderate to good consistency among our mixed geropsychiatric sample on brief measures of global cognition, attention, and visuospatial function...

Aging of the population is a growing concern in developed countries. Therefore, geriatric psychiatry has gradually emerged from general psychiatry. Many names have been proposed to term this sub-specialty: old age psychiatry (OAP), psychogeriatrics, geropsychiatry. A working group of the French federation of psychiatric trainees (AFFEP) set up an inventory of the theoretical instruction and clinical practice of OAP during the training of psychiatrists in France. Methods. A survey of both academic teaching and practical training for OAP was carried out in the 28 local AFFEP representatives of every French medical residency district, including overseas...

For almost everyone, the need for reading glasses is an inevitable part of the second half of life. Forgetting one's reading glasses at a restaurant can be a disturbing reminder of one's dependence on them. For geriatric inpatients, however, the value of reading glasses in improving quality of life and preventing delirium may be overlooked. Subsequently, the authors present a brief review of visual impairment, the relationship of visual impairment and cognition and the cost of reading glass, and the results of a survey that was conducted to determine the proportion of inpatient geriatric psychiatry inpatient units in the United States, which provide reading glasses to inpatients as well as to assess the knowledge of medical directors of these units regarding the cost and perceived value of providing reading glasses to hospitalized patients...

Geropsychiatry is a branch of psychiatry which focuses on the mental disorders of elderly people. Also known as psychiatry of old age, geriatric psychiatry or psychogeriatrics, this discipline provides people of retirement age with the psychological, somatic and social care which their health requires.

BACKGROUND: The number of patients with a cognitive disorder will increase significantly in the coming years due to demographic changes. The number of patients from this group requiring stationary treatment will inevitably increase in all medical specialties. The aim of our survey was to examine how hospitals are prepared with regard to nursing and treatment for the increasing number of patients with a cognitive disorder. Data were obtained concerning which problems in care have special significance and should play a central role in future considerations...

A brief review of literature on Late Paraphrenia is offered. An analysis was made on 15 cases of late paraphrenia with reference to its frequency, sex distribution, hallucinations, delusions and sensory impairment. Late Paraphrenia formed 4% of all Geropsychiatry cases. All the cases had hallucinations (100%) while 14 had delusions (93%). An associated auditory and/or visual defect was noticed in 13 of the cases (87%).Follow up findings revealed a sustained remission for 4 to 5 years with drugs in 12 patients (75%) and one patient died from cerebral stroke...

No abstract text is available yet for this article.

BACKGROUND: Professional organizations have recommended guidelines for the optimal investigation and management of dementia. It is unknown whether physicians from different subspecialties investigate and treat dementia in the same manner or according to these guidelines. METHODS: We screened 1,401 charts of patients who were seen in neurology, mental health, geropsychiatry and geriatrics clinics. The charts of 410 patients who were diagnosed with dementia were reviewed in detail to determine how they were evaluated and managed...

OBJECTIVE: THIS STUDY WAS CONDUCTED TO EXAMINE THE FOLLOWING: whether patients with mild cognitive impairment (MCI) show impairments in instrumental activities of daily living (IADL) as compared to controls; to identify the functional sub-domains of instrumental activities of daily living (IADL) that are affected in MCI and, finally, to identify the Seoul-Instrumental Activities of Daily Living (S-IADL) scale cut-off score that best differentiated between MCI and controls. METHODS: This study was carried out at the geropsychiatry clinic, university hospital...