Psychiatric disorders in older women

Lehmann, Susan W.

doi:10.1080/0954026031000136884

Cited by 20 publications

(2 citation statements)

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“…Although still common in older people, the point prevalence of BD decreases with age [20]. BD-I and II together may affect 0.5-1.0% of the elderly [21,22] with approximately 0.4% suffering from BD-I [23][24][25][26]. Within the elderly population seeking medical care, BD patients account for 6% of outpatients, 8-10% of geriatric hospital admissions, and 17% of elderly in psychiatric emergency rooms, with more than two-thirds being females [24,27,28].…”

Section: Epidemiologymentioning

confidence: 99%

Treatment of Bipolar Disorders in Older Adults: A Review

Ljubic,

Ueberberg,

Grunze

et al. 2023

FOC

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Background: Old age bipolar disorder has been an orphan of psychiatric research for a long time despite the fact that bipolar disorder (BD)-I and II together may affect 0.5-1.0% of the elderly. It is also unclear whether aetiology, course of illness and treatment should differ in patients with a first manifestation in older age and patients suffering from a recurrence of a BD known for decades. This narrative review will summarize the current state of knowledge about the epidemiology, clinical features, and treatment of BD in the elderly. Methods:We conducted a Medline literature search from 1970 to 2021 using MeSH terms "Bipolar Disorder" × "Aged" or "Geriatric" or "Elderly". Search results were complemented by additional literature retrieved from examining cross references and by hand search in text books. Summary of findings:Varying cut-off ages have been applied to differentiate old age from adult age BD. Within old age BD, there is a reasonable agreement of distinct entities, early and late-onset BD. They differ to some extent in clinical symptoms, course of illness, and some co-morbidities. Point prevalence of BD in older adults appears slightly lower than in working-age adults, with polarity of episodes shifting towards depression. Psychopharmacological treatment needs to take into account the special aspects of somatic gerontology and the age-related change of pharmacokinetic and pharmacodynamic characteristics. The evidence for commonly used treatments such as lithium, moodstabilizing antiepileptics, antipsychotics, and antidepressants remains sparse. Preliminary results support a role of ECT as well as psychotherapy and psychosocial interventions in old age BD. Conclusions:There is an obvious need of further research for all treatment modalities of BD in old age. The focus should be pharmacological and psychosocial approaches, as well as their combination, and the role of physical treatment modalities such as ECT.

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Section: Epidemiologymentioning

confidence: 99%

Treatment of Bipolar Disorders in Older Adults: A Review

Ljubic,

Ueberberg,

Grunze

et al. 2023

FOC

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“…In some cases, certain disorders such as depression might be considered to be a "normal" experience for older adults because of aging (Gallo, Ryan, & Ford, 1999;Laidlaw et al, 2003). Life stressors (such as caregiving for one's parent and child at the same time) also decrease the likelihood of baby boomers finding the time to engage in mental-health, help-seeking behaviors (Lehmann, 2003). As such, it is widely believed that reported prevalence rates of psychopathology among older adults are underestimations of the true prevalence of various mental disorders.…”

Section: Background About the Mental Health Treatment Of Older Adultsmentioning

confidence: 99%

Deconstructing Demons: The Case of Geoffrey

Mohlman

Cedeno

Price

et al. 2008

PCSP

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Research in late life mental health has not kept pace with the rapidly aging population of the U.S. Older adults (over age 65), more specifically the "baby boomer" cohort, are likely to pose unique challenges to mental health care providers. This report describes the case of Geoffrey, a 66-yearold African American male who presented with a complex range of psychiatric conditions (e.g., major depressive disorder, social anxiety disorder, and a history of polysubstance dependence), and challenging life circumstances (e.g., limited financial and social resources, and poorly controlled medical illness). Because Geoffrey also evidenced impairment in several cognitive domains (attention, memory, executive functions), a combined intervention of executive skills training (Sohlberg, Johnson, Paule, Raskin, & Mateer, 2001) and cognitive behavior therapy (CBT) was selected. Furthermore, because time for conducting therapy was limited (fourteen, 90-minute sessions over a ten-week period), a "transdiagnostic" approach was taken to maximize efficiency. Results suggest the utility of augmented, transdiagnostic therapies to achieve optimal response with older clients. Although Geoffrey's intervention progressed well, an event occurring late in treatment changed the course of therapy and led to an unexpected outcome. Several noteworthy aspects of the intervention, including the relevance of Geoffrey's case to the current aging trend in the U.S., the use of a combined transdiagnostic intervention, and aspects of the therapy process are discussed throughout.

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