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Late life mood disorders

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https://www.readbyqxmd.com/read/29088928/geri-bd-a-randomized-double-blind-controlled-trial-of-lithium-and-divalproex-in-the-treatment-of-mania-in-older-patients-with-bipolar-disorder
#1
RANDOMIZED CONTROLLED TRIAL
Robert C Young, Benoit H Mulsant, Martha Sajatovic, Ariel G Gildengers, Laszlo Gyulai, Rayan K Al Jurdi, John Beyer, Jovier Evans, Samprit Banerjee, Rebecca Greenberg, Patricia Marino, Mark E Kunik, Peijun Chen, Marna Barrett, Herbert C Schulberg, Martha L Bruce, Charles F Reynolds, George S Alexopoulos
OBJECTIVE: Clinicians treating older patients with bipolar disorder with mood stabilizers need evidence from age-specific randomized controlled trials. The authors describe findings from a first such study of late-life mania. METHOD: The authors compared the tolerability and efficacy of lithium carbonate and divalproex in 224 inpatients and outpatients age 60 or older with bipolar I disorder who presented with a manic, hypomanic, or mixed episode. Participants were randomly assigned, under double-blind conditions, to treatment with lithium (target serum concentration, 0...
November 1, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28990640/very-late-onset-schizophrenia-like-psychosis-a-clinical-update
#2
Elizabeth Cort, Jennifer Meehan, Suzanne Reeves, Robert Howard
Psychosis symptoms (delusions and hallucinations) are multifactorial in origin and, in later life, occur in the context of schizophrenia, delirium, dementia, delusional and schizophrenia-like disorders, mood disorders, and alcohol or substance abuse. The current article provides a clinical overview of very late-onset (after age 60) schizophrenia-like psychosis (VLOSLP), summarizing the literature on treatment options and reflecting on the role of psychiatric-mental health nurses (PMHNs). Increased awareness of the clinical presentation, key features, and evidence-based treatment options will assist PMHNs to confidently recognize this often under-diagnosed disorder and adopt a more assertive role in terms of engagement and follow up...
October 6, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28967771/examination-of-the-role-of-obesity-in-the-association-between-childhood-trauma-and-inflammation-during-pregnancy
#3
Amanda M Mitchell, Kyle Porter, Lisa M Christian
OBJECTIVE: Childhood trauma is associated with negative perinatal health outcomes including mood disorders and shorter gestation. However, effects of early life exposures on maternal biology are poorly delineated. This study examined associations between childhood trauma and inflammation, as well as the mediating role of obesity in this relationship. METHOD: This study examined a racially diverse sample of 77 pregnant women assessed in early, mid, and late pregnancy...
October 2, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28956334/a-role-for-phosphodiesterase-11a-pde11a-in-the-formation-of-social-memories-and-the-stabilization-of-mood
#4
Michy P Kelly
The most recently discovered 3',5'-cyclic nucleotide phosphodiesterase family is the Phosphodiesterase 11 (PDE11) family, which is encoded by a single gene PDE11A. PDE11A is a dual-specific PDE, breaking down both cAMP and cGMP. There are four PDE11A splice variants (PDE11A1-4) with distinct tissue expression profiles and unique N-terminal regulatory regions, suggesting that each isoform could be individually targeted with a small molecule or biologic. PDE11A4 is the PDE11A isoform expressed in brain and is found in the hippocampal formation of humans and rodents...
2017: Advances in Neurobiology
https://www.readbyqxmd.com/read/28948135/pharmacological-management-of-anxiety-disorders-in-the-elderly
#5
Elizabeth A Crocco, Sindy Jaramillo, Caroline Cruz-Ortiz, Katherine Camfield
Anxiety disorders are common in the elderly. Additionally, anxiety symptoms often accompany co-morbid psychiatric, medical, as well as neurodegenerative diseases in the older population. Anxiety in the elderly, often accompanied by depression, can lead to worsening physical, cognitive and functional impairments in this vulnerable population. Antidepressants are considered first line treatment. Both SSRIs and SNRIs are efficacious and well-tolerated in the elderly. Some SSRIs are strong inhibitors of the cytochrome P450 hepatic pathway whereas others have less potential for drug interaction...
March 2017: Current Treatment Options in Psychiatry
https://www.readbyqxmd.com/read/28860774/bipolar-ii-disorder-as-the-initial-presentation-of-cadasil-an-underdiagnosed-manifestation
#6
Jianjun Wang, Jinfang Li, Fanxin Kong, Hanqing Lv, Zhouke Guo
Mood disturbances have been documented in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The highly varied morbidity indicates that the affective symptoms in CADASIL have not been cataloged systematically, leading to ineffective treatment, affecting the patients' quality of life, and possibly resulting in suicide. We present a case of CADASIL with bipolar II disorder as the first manifestation. A middle-aged female reported recurrent depressive episodes and appeared treatment resistant to adequate dosages and durations of antidepressants...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28673741/long-term-effects-of-telephone-delivered-psychotherapy-for-late-life-gad
#7
Gretchen A Brenes, Suzanne C Danhauer, Mary F Lyles, Andrea Anderson, Michael E Miller
OBJECTIVE: To examine the long-term effects of telephone-delivered cognitive-behavioral therapy (CBT-T) compared with nondirective supportive therapy (NST-T) in rural older adults with generalized anxiety disorder (GAD). METHODS: 141 adults aged 60 years and older with a principal/co-principal diagnosis of GAD were randomized to either CBT-T or NST-T. CBT-T consisted of up to 11 sessions (9 were required) focused on recognition of anxiety symptoms, relaxation, cognitive restructuring and use of coping statements, problem-solving, worry control, behavioral activation, exposure therapy, and relapse prevention, with optional chapters on sleep and pain...
November 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28603719/prospective-study-of-quality-of-life-after-lung-cancer-resection
#8
Kathleen G Hopkins, Peter F Ferson, Manisha R Shende, Neil A Christie, Matthew J Schuchert, Arjun Pennathur
BACKGROUND: Surgical resection with curative-intent remains the gold standard for clinically operable early-stage non-small cell lung cancer (NSCLC). This goal can be accomplished using a minimally invasive option, e.g., video assisted thoracic surgery (VATS) or standard thoracotomy. Surgical techniques continue to evolve and few studies have compared the QOL of patients managed with these procedures using current approaches. The primary goal of this study was to investigate differences between patients managed surgically via VATS compared to thoracotomy with respect to ratings of chronic pain, anxiety/depression and quality of life (QOL)...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28543407/assessing-bipolar-disorder-in-the-older-adult-the-geri-bd-toolbox
#9
Patricia Marino, Herbert C Schulberg, Ariel G Gildengers, Benoit H Mulsant, Martha Sajatovic, Laszlo Gyulai, Rayan K Aljurdi, Laurie Davan Evans, Samprit Banerjee, Ruben C Gur, Robert C Young
INTRODUCTION: The evidence base regarding characteristics of older adults with bipolar disorder (BD) remains limited. The NIH-funded multicenter study Acute Pharmacotherapy of Late-Life Mania (GERI-BD) assessed various clinical domains before and during mood stabilizer treatment in older adults participating in a 9-week, double-blind randomized controlled trial. We describe the rationale for selecting these instruments. METHODS: Domains and instruments were selected on the basis of the study design and the participants...
May 22, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28527083/shared-mechanisms-of-epilepsy-migraine-and-affective-disorders
#10
Davide Zarcone, Simona Corbetta
Since the nineteenth century several clinical features have been observed in common between migraine and epilepsy (such as episodic attacks, triggering factors, presence of aura, frequent familiarity), but only in recent years researchers have really engaged in finding a common pathogenic mechanism. From studies of disease incidence, we understand how either migraine among patients with epilepsy or epilepsy among migraine patients are more frequent than in the general population. This association may result from a direct causality, by the same environmental risk factors and/or by a common genetic susceptibility...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28444658/comparing-the-immune-genomic-effects-of-vilazodone-and-paroxetine-in-late-life-depression-a-pilot-study
#11
Harris Eyre, Prabha Siddarth, Natalie Cyr, Hongyu Yang, Steve Cole, Malcolm Forbes, Helen Lavretsky
Vilazodone is a novel antidepressant agent that combines selective serotonin (5-HT) reuptake inhibitor (SSRI) activity and 5-HT(1A) receptor partial agonist activity. A pilot study was conducted to compare vilazodone (novel compound) and paroxetine (gold standard) on antidepressant effects, tolerability, and inflammation and immune modulation. A 12-week, double-blind, randomized clinical trial was conducted with 56 nondemented older adults diagnosed with major depressive disorder (MDD). Between-group differences in mood, tolerability, and safety, as well as genomic markers of inflammation and immune modulation, were examined...
November 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28434642/-late-life-depression-or-prodromal-alzheimer-s-disease-which-tools-for-the-differential-diagnosis
#12
A-I Gasser, V Salamin, S Zumbach
INTRODUCTION: Depression and Alzheimer's disease are both very frequent in elderly people. Cognitive deficits are the hallmark of Alzheimer's disease, but they are also common in depressed elderly people who often present cognitive deficits such as memory, attention and executive function problems. On the other hand, people with early Alzheimer's disease demonstrate emotional and behavioral disorders generally encountered in depression such as loss of energy, apathy, mood disorder, and irritability...
April 20, 2017: L'Encéphale
https://www.readbyqxmd.com/read/28365469/the-impact-of-frailty-on-depressive-disorder-in-later-life-findings-from-the-netherlands-study-of-depression-in-older-persons
#13
R M Collard, M H L Arts, A H Schene, P Naarding, R C Oude Voshaar, H C Comijs
BACKGROUND: Physical frailty and depressive symptoms are reciprocally related in community-based studies, but its prognostic impact on depressive disorder remains unknown. METHODS: A cohort of 378 older persons (≥60 years) suffering from a depressive disorder (DSM-IV criteria) was reassessed at two-year follow-up. Depressive symptom severity was assessed every six months with the Inventory of Depressive Symptomatology, including a mood, motivational, and somatic subscale...
January 24, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28331326/lithium-in-late-life-mania-a-systematic-review
#14
REVIEW
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
https://www.readbyqxmd.com/read/28306157/psychiatric-diagnoses-among-older-recipients-of-publicly-funded-mental-health-services
#15
Sarah T Stahl, Charles F Reynolds, Ellen M Whyte, Steven M Albert
OBJECTIVES: To compare the prevalence of psychiatric diagnoses among older recipients of publicly funded mental health services (county safety-net base services and Medicaid) to psychiatric diagnoses in an insured population of older adults from the same county. DESIGN: Secondary analysis of county human services claims data and claims from an insured population in the same county. SETTING: Inpatient and outpatient clinics in Allegheny County, PA...
July 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28161971/assessment-of-implicit-self-esteem-in-older-adults
#16
Ineke Demeyer, Nuria Romero, Rudi De Raedt
The interplay between actual and ideal self-esteem may be a key component in emotional disorders. Since automatic self-evaluations are not always consciously accessible, assessment through implicit measures is necessary. Given the lack of implicit self-esteem measures in late life, we aimed to identify a reliable measure and to clarify the role of actual and ideal self-esteem in mood and depressive symptoms in older adults. Forty-nine older adults completed two adapted Go/No go Association tasks measuring implicit actual and ideal self-esteem and measures of mood and depressive symptoms...
February 1, 2017: Assessment
https://www.readbyqxmd.com/read/28138119/the-normalization-of-brain-%C3%A2-%C3%A2-f-fluorodeoxy-d-glucose-positron-emission-tomography-hypometabolism-following-electroconvulsive-therapy-in-a-55-year-old-woman-with-treatment-resistant-late-onset-depression-a-case-report
#17
Jeongjae Bak, Sang Mi Lee, Young-Joon Kwon, Se-Hoon Shim, Joong Il Kim
Major depressive disorder, especially in later life, has heterogeneous clinical characteristics and treatment responses. Symptomatically, psychomotor retardation, lack of energy, and apathy tends to be more common in people with late-onset depression (LOD). Despite recent advances in psychopharmacologic treatments, 20% to 30% of patients with mood disorders experience inadequate responses to medication, often resulting in a trial of electroconvulsive therapy (ECT). However, the therapeutic mechanism of ECT is still unclear...
February 28, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27994004/biological-aging-and-the-future-of-geriatric-psychiatry
#18
REVIEW
Bret R Rutherford, Warren D Taylor, Patrick J Brown, Joel R Sneed, Steven P Roose
Advances in understanding the biological bases of aging have intellectually revitalized the field of geriatric psychiatry and broadened its scope to include promoting successful aging and studying resilience factors in older adults. To describe the process by which this paradigm shift has occurred and illustrate its implications for treatment and research of late-life brain disorders, late-life depression is discussed as a prototype case. Prior phases of geriatric psychiatry research were focused on achieving depressive symptom relief, outlining pharmacokinetic and pharmacodynamic differences between older and younger adults, and identifying moderators of treatment response...
March 1, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/27825555/neuroticism-traits-selectively-impact-long-term-illness-course-and-cognitive-decline-in-late-life-depression
#19
Kevin J Manning, Grace Chan, David C Steffens
OBJECTIVES: Neuroticism is a broad construct that conveys a predisposition to experience psychological distress and negative mood states. Vulnerability to stress (VS) is one neuroticism trait that has been linked to worse mood and cognitive outcomes in older adults. We hypothesized that elevated VS would be associated with worse illness course and cognitive decline in older adults with late-life major depression (LLD). DESIGN: Participants were enrolled in the Neurocognitive Outcomes of Depression in the Elderly (NCODE), a longitudinal investigation of the predictors of poor illness course and cognitive decline in LLD...
March 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27806704/vascular-depression-consensus-report-a-critical-update
#20
EDITORIAL
Howard J Aizenstein, Andrius Baskys, Maura Boldrini, Meryl A Butters, Breno S Diniz, Manoj Kumar Jaiswal, Kurt A Jellinger, Lev S Kruglov, Ivan A Meshandin, Milija D Mijajlovic, Guenter Niklewski, Sarah Pospos, Keerthy Raju, Kneginja Richter, David C Steffens, Warren D Taylor, Oren Tene
BACKGROUND: Vascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5(th) edition - a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term "MRI-defined vascular depression"...
November 3, 2016: BMC Medicine
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