Concise guide to geriatric psychiatry / James E. Spar, Asenath La Rue.

Format:

Book

Author/Creator:

Spar, James E.

Contributor:

La Rue, Asenath, 1948-

Series:

Concise guides (American Psychiatric Press)

Concise guides

Language:

English

Subjects (All):

Geriatric psychiatry--Handbooks, manuals, etc.

Geriatric psychiatry.

Mental Disorders.

Aged.

Medical Subjects:

Mental Disorders.

Aged.

Genre:

Handbooks and manuals.

Physical Description:

xxiii, 352 pages : illustrations ; 17 cm.

Edition:

Third edition.

Other Title:

Geriatric psychiatry

Place of Publication:

Washington, D.C. : American Psychiatric Pub., [2002]

Contents:

Contemporary Aging and Health Care 1

Mental Disorders in Later Life 7

Barriers to Geriatric Mental Health Care 9

Diversity in Patterns of Health and Aging 12

Working Effectively With Older Patients 14

2 Normal Aging 19

Conceptual Issues 19

Who Is Old? 19

Cross-Sectional and Longitudinal Views 20

Heterogeneity in Patterns of Aging 20

Cognitive Abilities in Later Life: A Processing Resource Model 21

Processing Speed 21

Working Memory 21

Sensory and Perceptual Changes 22

Neuropsychological Explanations of Cognitive Aging Changes 22

General Aging Trends 23

Factors That Influence Cognitive Aging 24

Learning and Memory 24

Impact of Cognitive Change on Everyday Function 29

Clinical Implications of Cognitive Change 30

Personality and Emotional Changes 34

Coexisting Stability and Change 34

Influences on Adult Personality 35

Emotions, Coping, and Well-Being 36

Clinical Implications of Personality and Emotional Change 38

The Social Context of Aging 39

Education, Work, and Financial Status 39

Marriage and Widowhood 41

Extended Families, Friends, and Group Involvement 42

Clinical Implications of Social Context 44

Biological Aging 45

What Is Aging? 45

Primary Aging: Strutural and Functional Changes 47

Treatment Implications of Biological Aging 47

3 Mood Disorders

Diagnosis 61

Major Depression 62

Epidemiology 62

Diagnostic Criteria 62

Variations in Clinical Presentation 63

Pathogenesis 74

Psychodynamic Theories 74

Cognitive and Behavioral Theories 75

Neurobiological Theories 75

Laboratory Evaluation 77

Rating Scales 78

Psychological Tests 81

Differential Diagnosis of Major Depression 81

Normal Grief (Bereavement) 85

Traumatic Grief 86

Substance-Induced Depression 87

Depression Due to a General Medical Condition 90

Stroke 90

Alzheimer's Disease and Vascular Dementia 91

The Vascular Depression Hypothesis 92

Parkinson's Disease 92

Dysthymic Disorder 93

Minor Depression 94

Characterologic Depression 95

Suicidality 95

Bipolar Mood Disorder 98

Epidemiology 98

Diagnostic Criteria 98

Clinical Presentation 98

Pathogenesis 98

Differential Diagnosis 101

4 Mood Disorders

Treatment 111

Psychosocial Treatment of Depression 111

Individual Therapy 111

Group Therapy 114

Family Therapy 114

Psychopharmacotherapy of Nonpsychotic Depression 115

First-Line Agents 121

Second-Line Agents 129

Pretreatment Evaluation for Tricyclic Antidepressants 130

Predictors of Response to Cyclic Antidepressants 131

Initiation and Dosage Adjustment of Cyclic Antidepressant Therapy 132

Management of Side Effects 133

Third-Line Agents 134

Strategies for Antidepressant Treatment Resistance 140

Maintenance Treatment 142

Psychopharmacotherapy of Psychotic Depression 142

Electroconvulsive Therapy 143

Complementary and Alternative Therapies 145

Bipolar Mood Disorder 146

Psychosocial Therapy 146

Psychopharmacotherapy 146

5 The Dementias and Alzheimer's Disease 153

Identifying the Dementia Syndrome 153

History 153

Mental Status Examination 153

Standardized Scales for Rating Cognition 154

Ratings of Everyday Behavior 160

Laboratory Evaluation 161

Neuropsychological Tests 161

Common Etiologies of Dementia 166

Alzheimer's Disease 166

Epidemiology

Risk Factors and Protective Factors 168

Genetics 170

Clinical Presentation 171

Pathogenesis 174

Diagnostic Criteria 177

Laboratory Evaluation 180

Neuropsychological Tests 180

Differential Diagnosis 181

Treatment 182

References for Dementia Caregivers 196

6 Other Dementias and Delirium 197

Frontotemporal Dementia 197

Epidemiology 197

Diagnostic Criteria 197

History, Clinical Presentation, and Mental Status Examination 199

Physical and Neurologic Examination 199

Neuropsychological Tests 199

Laboratory Findings 200

Pathology 200

Differential Diagnosis 201

Treatment 201

Dementia With Lewy Bodies 201

Epidemiology 203

Diagnostic Criteria 203

History 203

Clinical Presentation and Mental Status Examination 204

Physical and Neurologic Examination 204

Neuropsychological Tests 204

Pathology and Pathogenesis 205

Differential Diagnosis 205

Treatment 206

Vascular Dementia 206

Epidemiology 206

Diagnostic Criteria 206

History 208

Clinical Presentation and Mental Status Examination 208

Physical and Neurologic Examination 209

Laboratory Evaluation 209

Neuropsychological Tests 210

Pathogenesis 210

Differenetial Diagnosis 213

Treatment 214

Other Dementias 214

Dementia Due to Other General Medical Conditions 218

Substance-Induced Persisting Dementia 219

Reversible Dementia 219

Delirium 220

Epidemiology 220

Diagnostic Criteria 221

Clinical Presentation

History 221

Mental Status Examination 222

Pathogenesis 223

Laboratory Evaluation 223

Differential Diagnosis 225

Treatment 226

Prognosis 228

7 Anxiety Disorders 233

Epidemiology 233

Clinical Presentation 234

Differential Diagnosis of Anxiety Disorders 234

Situational Anxiety 234

Adjustment Anxiety 234

Generalized Anxiety Disorder 236

Phobic Anxiety 237

Obsessive-Compulsive Disorder 238

Panic Disorder 238

Mood Disorder With Anxiety 240

Schizophrenia With Anxiety 240

Pathogenesis 241

Psychodynamic Theories 241

Neurobiological Theories 242

Laboratory Evaluation 243

Anxiety Rating Scales 245

Treatment 245

Psychosocial-Behavior Therapy 245

Psychopharmacotherapy 246

8 Late-Onset Psychosis 253

Epidemiology 253

Diagnostic Criteria 254

Clinical Presentation 254

Pathogenesis 256

Psychodynamic Theories 256

Neurobiological Theories 257

Differential Diagnosis 258

Treatment 259

Psychosocial Therapy 259

Psychopharmacotherapy 260

9 Other Common Mental Disorders of the Elderly 267

Insomnia 267

Assessment 267

Differential Diagnosis 267

Primary Insomnia 270

Treatment 270

Substance Abuse 274

Alcoholism 274

Other Psychoactive Substance Abuse 278

Sexual Dysfunction 281

Sexual Dysfunction Versus Normal Aging Changes 281

Sexual Dysfunction and Physical Illness 283

Sexual Dysfunction and Medications 284

Treatment 284

Psychiatric Illness Related to a General Medical Condition 285

Personality Change Due to a General Medical Condition 285

Psychotic Disorder Due to a General Medical Condition 286

Chronic Pain 287

Influence of Aging on Disorders of Early Onset 288

Mood Disorders 288

Schizophrenia 288

Personality Disorders 288

10 Competency and Related Forensic Issues 293

Competency to Give Informed Consent for Medical Care 294

Competency to Execute an Advance Directive 295

Competency to Consent to Enrollment in a Research Study 298

Competency to Enter Into a Contract or Make a Gift 299

Competency to Make a Will 300

Competency to Execute a Trust 302

Undue Influence: The Question of Voluntariness 302

Competency to Care for Oneself and Manage One's Finances 305

Expert Consultation and Testimony on Competency 309

Appendix Clinical Assessment Instruments 313

Geriatric Depression Scale 314

Beck Depression Inventory: Instructions and Sample Items 316

Mental Status Questionnaire 317

The Six-Item Orientation-Memory-Concentration Test 318

Cognistat Profile: Example 319

Overview of the Mattis Dementia Rating Scale 320

Overview of the Cognitive Abilities Screening Instrument (CASI) 321

Instrumental Activities of Daily Living (IADL) Scale 322

Revised Memory and Behavior Problems Checklist 324

Items Rated on the Neuropsychiatric Inventory 326

Items Rated on the Delirium Rating Scale 327.

Notes:

Includes bibliographical references and index.

ISBN:

1585620645

OCLC:

48435825