Mania in Old Age: A Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
L.C. Castro
Keyword(s):  
Bipolar Disorder ◽  
Old Age ◽  
Multidisciplinary Approach ◽  
Bipolar Affective Disorder ◽  
Late Life ◽  
The Elderly ◽  
Medical Conditions ◽  
Holistic Treatment ◽  
Co Morbidity ◽  
The Impact

Background:Geriatric bipolar disorder is associated with a significant morbidity, mortality and poor psychosocial outcomes. Bipolar affective disorder contributes substantially to geriatric mood disorders and to geriatric hospitalizations. Mania in late-life is often a tremendous treatment challenge because of frequent medical co-morbidity and age-related variations in response to therapeutics.Aim:To report a case of mania in late-life, in order to discuss the impact of bipolar disorder in the elderly, underlining treatment difficulties in the geriatric population.Methods:Case study and review of the literature.Results:A 70 year old woman was hospitalized in a geriatric service of a psychiatric hospital with a maniac episode. She had a history of bipolar disorder diagnosed during her adult life. She had several co-morbid medical conditions, including diabetes, hypertension, dyslipidemia and psoriasis. There was a successful multidisciplinary approach and intervention, allowing a significant improvement and reintegration in the community.Conclusions:Geriatric patients with bipolar disorder carry a substantial burden of general medical conditions. There are few studies and a lack of specific algorithms concerning bipolar management in the elderly. It is urgent the development of specific interventions that target medical burden in patients with bipolar disorder and further research on the treatment of bipolar disorder in old age. A multidisciplinary approach is essential to allow a holistic treatment and improvement of quality of life parameters in this population.

scholarly journals Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R)

2009 ◽  
Vol 40 (2) ◽  
pp. 225-237 ◽  
Author(s):  
R. C. Kessler ◽  
H. Birnbaum ◽  
E. Bromet ◽  
I. Hwang ◽  
N. Sampson ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Old Age ◽  
Age Differences ◽  
Late Life ◽  
The Elderly ◽  
National Comorbidity Survey Replication ◽  
National Comorbidity Survey ◽  
Co Morbidity ◽  
Physical Disorders ◽  
Dsm Iv

BackgroundAlthough depression appears to decrease in late life, this could be due to misattribution of depressive symptom to physical disorders that increase in late life.MethodWe studied age differences in major depressive episodes (MDE) in the National Comorbidity Survey Replication, a national survey of the US household population. DSM-IV MDE was defined without organic exclusions or diagnostic hierarchy rules to facilitate analysis of co-morbidity. Physical disorders were assessed with a standard chronic conditions checklist and mental disorders with the WHO Composite International Diagnostic Interview (CIDI) version 3.0.ResultsLifetime and recent DSM-IV/CIDI MDE were significantly less prevalent among respondents aged ⩾65 years than among younger adults. Recent episode severity, but not duration, was also lower among the elderly. Despite prevalence of mental disorders decreasing with age, co-morbidity of hierarchy-free MDE with these disorders was either highest among the elderly or unrelated to age. Co-morbidity of MDE with physical disorders, in comparison, generally decreased with age despite prevalence of co-morbid physical disorders usually increasing. Somewhat more than half of respondents with 12-month MDE received past-year treatment, but the percentage in treatment was lowest and most concentrated in the general medical sector among the elderly.ConclusionsGiven that physical disorders increase with age independent of depression, their lower associations with MDE in old age argue that causal effects of physical disorders on MDE weaken in old age. This result argues against the suggestion that the low estimated prevalence of MDE among the elderly is due to increased confounding with physical disorders.

Bidirectional relationships between general medical conditions and bipolar disorder: treatment considerations

2017 ◽  
Author(s):  
Nefize Yalin ◽  
Danilo Arnone ◽  
Allan Y. Young
Keyword(s):  
Bipolar Disorder ◽  
Allostatic Load ◽  
Premature Mortality ◽  
Medical Conditions ◽  
Risk Minimization ◽  
Unhealthy Lifestyle ◽  
Lifestyle Choices ◽  
Co Morbidity ◽  
Treatment Considerations ◽  
Underlying Causes

Increased medical co-morbidity is one of the underlying causes of excess and premature mortality in bipolar disorder. This increased prevalence of medical conditions is likely to result from a range of different factors. Some attention in recent years has been devoted to intrinsic illness factors resulting in excessive allostatic load and oxidative stress potentially predisposing to physical morbidity. Some other contributors have also been identified as unhealthy lifestyle habits and unwanted effects of pharmacological treatment. Irrespective of causality, risk minimization can be obtained by systematically addressing physical needs into the management of bipolar disorder. This can be achieved with a range of interventions including regular monitoring of physical health, tailored management of unhealthy lifestyle choices, and pharmacological optimization.

Overview of Late-Life Depression

2015 ◽  
Author(s):  
Mark D. Miller
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Personality Disorders ◽  
Collaborative Care ◽  
Late Life ◽  
Medical Conditions ◽  
Late Life Depression ◽  
Alcohol Treatments

Chapter 4 outlines late-life depression. It explores the causes of depression (including medical conditions, medication, and alcohol), treatments for depression, and other diagnoses (bipolar disorder, co-occuring anxiety, and personality disorders), depression and cognitive impairment, and collaborative care.

scholarly journals Does money empower the elderly? Evidence from the Agincourt demographic surveillance site, South Africa1

2007 ◽  
Vol 35 (69_suppl) ◽  
pp. 157-164 ◽  
Author(s):  
Anne Case ◽  
Alicia Menendez
Keyword(s):  
South African ◽  
Old Age ◽  
The Elderly ◽  
Social Pension ◽  
Alternative Means ◽  
Health And Development ◽  
Adults And Children ◽  
Socioeconomic Data ◽  
The Impact ◽  
To Receive

Aims: To quantify the impact of the South African old age (social) pension on outcomes for pensioners and the prime-aged adults and children who live with them, and to examine alternative means by which pensions affect household outcomes. Methods: We collected socioeconomic data on 290 households in the Agincourt demographic surveillance area (DSA), stratifying our sample on the presence of a household member age-eligible for the old-age pension (women aged 60 and older, men aged 65 and older). Results: The presence of a pensioner significantly reduces household reports that adults and, separately, children missed meals because there was not enough money for food. In addition, girls are significantly more likely to be enrolled in school if they are living with a pensioner, an effect that is driven entirely by living with a female pensioner. Our results are consistent with a model in which pensioners have a greater say in household functioning once they begin to receive their pensions. Conclusions: We find a program targeted toward the elderly plays a significant role in children's health and development.

The Duration of Undiagnosed Bipolar Disorder: Impact of Substance use Disorders co-morbidity

2017 ◽  
Vol 41 (S1) ◽  
pp. S132-S132
Author(s):  
S. Ben Mustapha ◽  
W. Homri ◽  
L. Jouini ◽  
R. Labbane
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Standard Deviation ◽  
Substance Use Disorders ◽  
Mood Stabilizer ◽  
Type I ◽  
Addictive Behaviour ◽  
Bipolar Disease ◽  
Co Morbidity ◽  
The Impact

AimsStudy the impact of substance use disorders (SUD) co-morbidity on the duration of undiagnosed bipolar disorder (DUBP).MethodsCase-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity. In our study DUBP was defined as the period between the first symptoms and the beginning of treatment by a mood stabilizer.ResultsThe beginning of addictive behaviour preceded the installation of bipolar disease in 32% of cases. Installation of bipolar disorder preceded the installation of addictive behaviour in 12% of cases. The beginning of addictive behaviour was concomitant with the installation of bipolar disease in 6% of cases. The average DUBP in the full sample was 4.80 years with a standard deviation of 8.04 and extremes ranging from 0.08 to 37.5.The average DUBP in patients with SUD co-morbidity was 5.91 years with a standard deviation of 8.16 and extremes ranging from 0.08 to 35, and 3.68 years with a standard deviation of 7.84 and extremes ranging from 0.08 to 37.5 in patients without SUD co-morbidity.ConclusionsAccording to studies over two thirds of patients with bipolar disorder received misdiagnoses before diagnosis of BD, and among the factors involved can report the presence of SUD co-morbidity. Hence, we should detect BD among patients with SUD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Treatment of psychoses in the elderly

1996 ◽  
Vol 2 (3) ◽  
pp. 133-139
Author(s):  
A. Phanjoo
Keyword(s):  
Old Age ◽  
Psychotic Disorders ◽  
De Novo ◽  
Late Onset ◽  
Late Life ◽  
The Elderly ◽  
Functional Psychoses ◽  
First Time ◽  
Paranoid Psychosis

Psychotic disorders in the elderly can be divided into three types: disorders that have started in earlier life and persist into old age; disorders that start de novo after the age of 60, and psychoses associated with brain disease, including the dementias. The classification of psychoses in late life has provoked controversy for nearly a century. The debate concerns whether schizophrenia can present at any stage of life or whether functional psychoses, arising for the first time in late life, represent different illnesses. The nomenclature of such disorders consists of numerous terms including late onset schizophrenia, late paraphrenia, paranoid psychosis of late life and schizophreniform psychosis. This plethora of terms has made research difficult to interpret.

New Onset Rapid Cycling Bipolar Disorder in an 87 Year Old Woman

1993 ◽  
Vol 38 (5) ◽  
pp. 324-326 ◽  
Author(s):  
William Gnam ◽  
Alastair J. Flint
Keyword(s):  
Bipolar Disorder ◽  
Late Life ◽  
The Elderly ◽  
Rapid Cycling ◽  
Pharmacological Management ◽  
New Onset

New onset rapid cycling bipolar disorder is rare in late life. The authors report the case of an 87 year old woman who first developed this disorder at age 82 and was successfully treated with valproate and L-thyroxine. The contribution of aging, hypothyroidism and stroke to the etiology of this woman's disorder is discussed. The pharmacological management of rapid cycling bipolar disorder in the elderly is also reviewed.

NEW APPROACHES TO THE OLD PROBLEMS. HYPERTENSION IN THE GERIATRIC PATIENTS

2020 ◽  
pp. 515-526
Author(s):  
Е. А. Темникова ◽  
А. И. Кондратьев ◽  
М. В. Темников
Keyword(s):  
Old Age ◽  
Elderly Population ◽  
Geriatric Patients ◽  
The Elderly ◽  
Diagnosis And Treatment ◽  
Noncommunicable Diseases ◽  
The World ◽  
Very Old Age ◽  
Modern Information ◽  
The Impact

Значительное увеличение численности лиц пожилого и старческого возраста во всём мире ведёт к возрастанию актуальности проблем сохранения здоровья и адекватной медицинской помощи гериатрическим пациентам. Особое значение приобретают своевременная диагностика и лечение хронических неинфекционных заболеваний, частота которых с возрастом значительно нарастает. Артериальная гипертензия в пожилом и старческом возрасте всегда вызывала особое внимание исследователей и практических врачей из-за её распространённости, меняющихся подходов к диагностике и оценке влияния на прогноз, различающихся неоднозначных предложений по ведению возрастных пациентов. В обзоре представлены данные международных и отечественных исследований и рекомендаций по вопросам патофизиологии артериальной гипертензии, особенностям её диагностики и лечения в различных клинических ситуациях. A significant increase of the elderly population over the world leads to an increasing the relevance of the problems of maintaining health and adequate medical care for geriatric patients. Timely diagnosis and treatment of chronic noncommunicable diseases, the frequency of which increases with age, have been the particular importance. The researchers and practicing doctors have always paid special attention to hypertension in old and very old age due to its prevalence, changeable approaches to diagnosis and assessment of the impact on the prognosis, various ambiguous proposals for the management of the patients. Modern information about the international and domestic researches and recommendations on the issues of the pathophysiology of hypertension, features of its diagnosis and treatment in various clinical situations is presented in the review.

Mood disorders in the elderly

2012 ◽  
pp. 1550-1558
Author(s):  
Robert Baldwin
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Late Life ◽  
Later Life ◽  
The Elderly ◽  
Clinical Syndrome ◽  
Late Life Depression ◽  
Increased Risk

This chapter considers some of the commonly asked questions about mood disorders in later life. Is depression in later life a distinct clinical syndrome? How common is it? Is there an organic link, for example to cerebral changes, and if so, is there an increased risk of later dementia? Is it more difficult to diagnose and treat late-life depression, and once treated, is the outcome good, bad, or indifferent? The emphasis will be on depression but bipolar disorder and mania will also be considered.

Sign in / Sign up

Export Citation Format

Share Document