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This work guides clinicians through the assessment and management of depression, mild cognitive impairment (MCI), and early dementia. Its focus on office-based management, emphasis on practical interventions, use of case studies to illustrate teaching points, and non-academic language are particular strengths
Troublesome Disguises examines psychiatric conditions which are not necessarily uncommon, rare or exotic but are challenging for the clinician who may struggle to reach a diagnosis and to set up management strategies. However, with familiarity, these conditions can and should be recognised. This new edition is an exercise in consciousness-raising as well as a warning to beware of diagnostic systems which, despite their many virtues, may become too influential and may perpetuate errors which are to the detriment of patients. For the clinician struggling to understand and treat patients who fail to fit the usual diagnostic categories, Troublesome Disguises provides wise instruction in the virtue of entertaining doubts, as well as practical advice for the assessment and management of atypical cases.
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.
This handy DSM-5(R) Classification provides a ready reference to the DSM-5 classification of disorders, as well as the DSM-5 listings of ICD-9-CM and ICD-10-CM codes for all DSM-5 diagnoses. To be used in tandem with DSM-5(R) or the Desk Reference to the Diagnostic Criteria From DSM-5(R), the DSM-5(R) Classification makes accessing the proper diagnostic codes quick and convenient. With the advent of ICD-10-CM implementation in the United States on October 1, 2015, this resource provides quick access to the following: - The DSM-5(R) classification of disorders, presented in the same sequence as in DSM-5(R), with both ICD-9-CM and ICD-10-CM codes. All subtypes and specifiers for each DSM-5(R) disorder are included.- An alphabetical listing of all DSM-5 diagnoses with their associated ICD-9-CM and ICD-10-CM codes.- Separate numerical listings according to the ICD-9-CM codes and the ICD-10-CM codes for each DSM-5(R) diagnosis.- For all listings, any codable subtypes and specifiers are included with their corresponding ICD-9-CM or ICD-10-CM codes, if applicable. The easy-to-use format will prove indispensable to a diverse audience--for example, clinicians in a variety of fields, including psychiatry, primary care medicine, and psychology; coders working in medical centers and clinics; insurance companies processing benefit claims; individuals conducting utilization or quality assurance reviews of specific cases; and community mental health organizations at the state or county level.
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
The author demarcates the current body of knowledge relevant to the clinical care of elders experiencing depression.
An overview of important current subjects in old age psychiatry, demonstrating the depth and breadth of the speciality.
At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.
Two of the most common psychological disorders of later life are dementia and depression. The diagnosis of these conditions presents a challenge to clinicians because the symptoms of depression and dementia often overlap; in addition, the symptoms of either of these disorders in their early stages may be attributed to the normal effects of aging. [This book] reviews the most up-to-date research on the diagnosis of dementia and depression [in older adults] and offers concrete recommendations for evaluating this unique population. The contributors to this volume, all experts in the psychological assessment of older adults, give clinicians and practitioners clear and practical guidance on differentiating psychological disorders from normal events in the aging process, identifying symptoms of depression and symptoms of dementia, performing differential assessment of dementia and depression, determining legal competency of older adults, providing clinical interpretations to clients and their families, and applying assessment to therapy and interventions.
Societies around the world are concerned about dementia and the other forms of cognitive impairment that affect many older adults. We now know that brain changes typically begin years before people show symptoms, which suggests a window of opportunity to prevent or delay the onset of these conditions. Emerging evidence that the prevalence of dementia is declining in high-income countries offers hope that public health interventions will be effective in preventing or delaying cognitive impairments. Until recently, the research and clinical communities have focused primarily on understanding and treating these conditions after they have developed. Thus, the evidence base on how to prevent or delay these conditions has been limited at best, despite the many claims of success made in popular media and advertising. Today, however, a growing body of prevention research is emerging. Preventing Cognitive Decline and Dementia: A Way Forward assesses the current state of knowledge on interventions to prevent cognitive decline and dementia, and informs future research in this area. This report provides recommendations of appropriate content for inclusion in public health messages from the National Institute on Aging.