Late Life Depression An Issue Of Psychiatric Clinics

Apart from Alzheimer's dementia, depressive disorders are emerging to account for the next greatest share of disability among older adults. Depressive illnesses complicate the recovery of many important medical illnesses and are associated with suicide death in the elderly at rates exceeding those seen in young adults. This issue of Psychiatric Clinics provides information for general adult psychiatrists, internal medicine geriatricians, and primary care physicians and care extenders to enable them to meet the most basic needs of depressed older adults. Topics in this issue address the questions: What is late life depression? What are the unique cognitive deficits seen in late life depression? What is the nature of the two-way relationship between medical illness and depression in late life depression? What complications arise from late life depression? What is the relationship between late life depression and dementing illnesses? What assessments should be done of the person with suspected late life depression? What are the psychological treatments for late life depression? What is the role of medications in late life depression? What is the role of alternative treatments in late life depression? Is there a role for ECT/TMS/VNS in late life depression? Vaughn McCall of Georgia Health Sciences University provides his expertise to lead this issue.

Apart from Alzheimer's dementia, depressive disorders are emerging to account for the next greatest share of disability among older adults. Depressive illnesses complicate the recovery of many important medical illnesses and are associated with suicide death in the elderly at rates exceeding those seen in young adults. This issue of Psychiatric Clinics provides information for general adult psychiatrists, internal medicine geriatricians, and primary care physicians and care extenders to enable them to meet the most basic needs of depressed older adults. Topics in this issue address the questions: What is late life depression? What are the unique cognitive deficits seen in late life depression? What is the nature of the two-way relationship between medical illness and depression in late life depression? What complications arise from late life depression? What is the relationship between late life depression and dementing illnesses? What assessments should be done of the person with suspected late life depression? What are the psychological treatments for late life depression? What is the role of medications in late life depression? What is the role of alternative treatments in late life depression? Is there a role for ECT/TMS/VNS in late life depression? Vaughn McCall of Georgia Health Sciences University provides his expertise to lead this issue.

Exploring the causes, manifestations, and consequences of late-life depression, this reference examines treatments and approaches for the management of this condition, highlighting methods for the recognition of depression in the medically ill, clinically demented, and bereaved, as well as for assessment of the efficacy of these treatment.

This issue covers a broad selection of topics critical to psychiatrist and any physician who treats older patients. Topics include: Epidemiology, clinical evaluation, and treatment of dementing disorders, late-life psychosis; suicide in late life; depression in primary care; structural neuroimaging of geriatric depression; gene-environment interactions in geriatric depression; treatment of geriatric depression; etiological Theories of Late-Life depression; geriatric bipolar disorder; psychotherapies in geriatric depression; home-based care of the elderly with mental disorders; functional neuroimaging in geriatric depression; models of treatment engagement of geriatric persons with mental disorders; and mental health service delivery to the elderly.

This issue of Psychiatric Clinics, edited by Drs. Dan Blazer and Susan Schultz, will cover a number of important aspects of Geriatric Psychiatry. Topics in this issue include, but are not limited to: Delirium in the elderly; Depression and cardiac disease in later life; Schizophrenia in later life; Anxiety Disorders in later life; Neurological changes and depression; Behavioral Changes with Alzheimer’s Disease and Vascular Dementia; Palliative Care in Dementia and Chronic Mental Illness; Collaborative Care for the elderly with psychiatric disorders; and Post Traumatic Stress Disorders in the elderly.

We live in an aging world. Illnesses that are prevalent and cause significant morbidity and mortality in older people will consume an increasing share of health care resources. One such illness is depression. This illness has a particularly devastating impact in the elderly because it is often undiagnosed or inadequately treated. Depression not only has a profound impact on quality of life but it is associated with an increased risk of mortality from suicide and vascular disease. In fact for every medical illness studied, e.g. heart disease, diabetes, cancer, individuals who are depressed have a worse prognosis. Research has illuminated the physiological and behavioral effects of depression that accounts for these poor outcomes. The deleterious relationship between depression and other illnesses has changed the concept of late-life depression from a "psychiatric disorder" that is diagnosed and treated by a psychiatrist to a common and serious disorder that is the responsibility of all physicians who care for patients over the age of 60. This is the first volume devoted to the epidemiology, phenomenology, psychobiology, treatment and consequences of late-life depression. Although much has been written about depressive disorders, the focus has been primarily on the illness as experienced in younger adults. The effects of aging on the brain, the physiological and behavioral consequences of recurrent depression, and the impact of other diseases common in the elderly, make late-life depression a distinct entity. There is a compelling need for a separate research program, specialized treatments, and a book dedicated to this disorder. This book will be invaluable to psychiatrists, gerontologists, clinical psychologists, social workers, students, trainees, and others who care for individuals over the age of sixty.

What are the special considerations that apply to the diagnosis and treatment of depression in late life? The NIH Consensus Development Conference set out to address this topic in detail; Diagnosis and Treatment of Depression in Late Life presents their findings. Compiled by experts in the field, Diagnosis and Treatment of Depression in Late Life provides comprehensive studies on early-life depression versus late-life depression, the prevalence of depression in elderly people and the risk factors involved, issues regarding safe and effective treatment, the patterns for health service use, and the consequences of unrecognized or inadequately treated depression.

This book contains a comprehensive review of the current research advances in late life mood disorders. This detailed review reflects the new understanding of neurobiology and psychosocial origins of geriatric mood disorders in the first decade of the 21st Century and is provided by the international group of leading experts in the field. The review of the latest developments and "gold standards" of care or methodologies in geriatric mood disorders is complemented by the anticipated future directions of research and translation into clinical practice. Our volume targets a broad audience of clinical researchers and clinicians. The content of the book will increase clinicians' and researcher's competency in recent research findings, and broaden their diagnostic and therapeutic perspectives and power of observation that will prepare them to deal with the challenges of finding appropriate effective treatments for older adults with mood disorders. The discussion of the data is presented in a textbook format and can be used for training of students of geriatric mental health. Individual chapters can be used as references on a particular topic for interested individuals, and obtained online. Clinicians and researchers who are dedicated to the treatment and study of mood disorders in older people might consider this volume an essential part of their library.