Geriatric Psychiatry

A report of dropoffs of elderly individuals at hospitals, elderly persons being reported for socially inappropriate behavior, and an increase in 911 calls concerning elderly relatives with dementia attacking family members and caregivers.

Excellence in psychopharmacology demands sensitivity to the associated ethical considerations. The key considerations of psychiatry are both complex and dynamic, and psychiatrists who develop and refine their ethics skill set will be in a better position to anticipate and respond to ethical dilemmas as they arise in their practice.

One of the most remarkable discoveries in the field of life span alteration occurred in the past century and has to do with caloric restriction.

The title of Gardiner Harris’s front-page story in the March 6 New York Times was blunt: “Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy.” For those of us who see our profession as a humanistic calling, this piece is likely to provoke a mixture of sadness and anger.

Major mood disorders have been associated with increased suicidal behavior. This is especially true in patients with a mixed, manic-depressive, or dysphoric-agitated state.

Psychiatrists face some unappetizing developments with regard to Medicare fees starting January 1, 2011. The terms of the new benefits are not nearly as specific as mental health groups pressed for.

The team approach to dementia psychiatry services requires leadership for direction, decision making, and policy changes in order to make the process efficient and beneficial for all involved.

It is not surprising that one of the most complicated aspects of collaboration with faculty and staff in the ED setting is the professional or social contract.

As I lie in my hospital bed, attempting to breathe through my trach tube at a normal rate, waiting for my morning medication, and hoping to hear good, or at least manageable, results from my doctors when they come to me on rounds, my mind wanders. Despite the precariousness of my situation, I can’t help but smile as I think of my now monthly psychotherapy sessions.

For some patients with MDD, there are indeed “remembered gifts” that are appreciated on recovery from their depression. But this is not to say that MDD itself is “adaptive” during the course of the patient’s illness.

Would you be surprised to find out that Freud is gaining a foothold in China? As psychoanalysis and related therapies are slipping in the USA, psychoanalysts from the US are beginning to train a cadre of interested clinicians in China.

Depression, cognitive impairment, and disability often coexist in older adults. Therefore, to effectively treat late-life depression, clinicians need to evaluate the presence and degree of the patient’s cognitive deficits and level of disability.

Focus on Obesity, Insulin Resistance, and the Metabolic Syndrome

The aging of the world’s populations represents one of the most remarkable success stories in medicine and of humankind, but it is also a source of various challenges.

With the transition of patients with mental illness from the beds of psychiatric institutions into the community the need for knowledgeable mental health professionals continues to grow. Correctional psychiatry has evolved in recent years and presents special challenges for clinicians, which this handbook deftly addresses. Contributing authors with various backgrounds provide a broad range of expertise.

The goal of palliative care is to prevent and relieve suffering and to improve quality of life for people facing a serious, complex illness.

An Overview of Antipsychotic Use in Older Adults

Who should care about aging? This question is particularly germane in mental health. The articles in this Special Report remind us of the importance of understanding and focusing on the stresses, problems, and treatment-related issues in this population.

Researchers who have spent their careers studying schizophrenia and mood disorders might be forgiven a bit of “biomarker envy.” At long last, it seems that the neurologists and neuropsychiatrists have developed some fairly sensitive and specific “lab tests” for Alzheimer’s Disease (AD).

Keys to diagnosis, assessment, and management.

As with all medical emergencies, psychiatric emergencies are among the most clinically challenging situations.

At the end of life, psychiatrists are often asked to assess a patient’s capacity to refuse treatment, but the role of the psychiatrist in this situation is much broader.

Nothing can replace talking with patients. This can take substantial amounts of time, but it is the only way to obtain as clear a view as possible about whether a patient is benefiting from treatment.

Almost the first memory I have of a physician is our family doctor at my bedside, leaning over to press his warm fingers against my neck and beneath my jaw. I’m 5, maybe 6 years old. I have a fever and a sore throat, and Dr Gerace is carefully palpating my cervical and submandibular lymph nodes. In my family, Dr Gerace’s opinion carried a lot of weight. It was the 1950s, and my mother did not quite trust those new-fangled antibiotics. She usually tried to haggle with the doctor over the dose-“Can’t the boy take just half that much?”-but even my mother would ultimately bow to Dr Gerace’s considered opinion.

Help in Clinical Decision Making

The impact of FDA alerts and label warnings was examined in 2 recently published studies of antipsychotic drug use. In one study, researchers gauged physician response to the 2005 warning of increased mortality with antipsychotic use in elderly patients with dementia, and in the other study, researchers determined whether recommended safeguards were implemented following the 2003 advisories on adverse metabolic effects of second-generation antipsychotics.

Dateline: Portland, Oregon, April, 2011[From the office notes of Prescribing Psychologist, R.X. Sciolus, PhD]“Ms Malfortuna is a 60-year-old white female with a recent history of significant depressive symptoms, including insomnia, poor appetite, decreased energy, anhedonia, and lack of motivation. . .

Posted on February 3, I asked the question, CAUTION! Who Should Be the DSM5 Diagnostician? I suggested that we needed to pay as much attention to who would be designated as the diagnostician as on the revised diagnostic criteria.

Mr V had appeared at our appointment in a panic, after an episode of premature ventricular contractions and a terrifying nightmare. In the dream, he was threatened by a blue, masklike face with white circles for eyes and 2 slits for a nose.

Resources, books, and practice guidelines