Late-Life Mood Disorders and Home-Based Services and Interventions

2013 ◽  
pp. 532-545
Keyword(s):  
Mood Disorders ◽  
Late Life ◽  
Home Based

Maintenance Interpersonal Psychotherapy (IPT-M)

2012 ◽  
pp. 341-364
Author(s):  
Mark D Miller ◽  
Ellen Frank ◽  
Jessica C Levenson
Keyword(s):  
Mood Disorders ◽  
Late Life ◽  
Interpersonal Psychotherapy ◽  
Personality Pathology ◽  
Protective Effects ◽  
Optimal Frequency ◽  
Term Efficacy ◽  
Psychotherapeutic Interventions ◽  
Over Time

Chapter 19 covers maintenance interpersonal psychotherapy (IPT-M), and that while effective psychotherapeutic and pharmacotherapeutic acute treatments for depression are well known, the problem of how to prevent relapse and recurrence has been a vexing one. It describes some of the studies designed to test the protective effects of maintenance pharmacotherapy and psychotherapy against relapse and recurrence, how with pharmacotherapy, judging long-term efficacy simply requires monitoring patients on a given dose of medication over time, but how psychotherapeutic interventions raise other issues. It covers IPT-M for late-life mood disorders, personality pathology, optimal frequency of IPT-M, research in this area, and a case example.

scholarly journals Mood Disorders in Late Life: A Population-based Analysis of Prevalence, Risk Factors, and Consequences in Community-dwelling Older Adults in Ontario: Troubles de l’humeur en âge avancé : Une analyse dans la population de la prévalence, des facteurs de risque et des conséquences chez des adultes âgés vivant en milieu communautaire en Ontario

2020 ◽  
Vol 65 (9) ◽  
pp. 630-640
Author(s):  
Rachel Strauss ◽  
Paul Kurdyak ◽  
Richard H. Glazier
Keyword(s):  
Risk Factors ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Potential Risk ◽  
Late Life ◽  
Population Based ◽  
Community Dwelling ◽  
Self Report ◽  
Term Care ◽  
Potential Risk Factors

Objective: Mental health issues in late life are a growing public health challenge as the population aged 65 and older rapidly increases worldwide. An updated understanding of the causes of mood disorders and their consequences in late life could guide interventions for this underrecognized and undertreated problem. We undertook a population-based analysis to quantify the prevalence of mood disorders in late life in Ontario, Canada, and to identify potential risk factors and consequences. Method: Individuals aged 65 or older participating in 4 cycles of a nationally representative survey were included. Self-report of a diagnosed mood disorder was used as the outcome measure. Using linked administrative data, we quantified associations between mood disorder and potential risk factors such as demographic/socioeconomic factors, substance use, and comorbidity. We also determined associations between mood disorders and 5-year outcomes including health service utilization and mortality. Results: The prevalence of mood disorders was 6.1% (4.9% among males, 7.1% among females). Statistically significant associations with mood disorders included younger age, female sex, food insecurity, chronic opioid use, smoking, and morbidity. Individuals with mood disorders had increased odds of all consequences examined, including placement in long-term care (adjusted odds ratio [OR] =2.28; 95% confidence interval [CI], 1.71 to 3.02) and death (adjusted OR = 1.35; 95% CI, 1.13 to 1.63). Conclusions: Mood disorders in late life were strongly correlated with demographic and social/behavioral factors, health care use, institutionalization, and mortality. Understanding these relationships provides a basis for potential interventions to reduce the occurrence of mood disorders in late life and their consequences.

Mood Disorders in Late Life

2016 ◽  
pp. 298-310
Author(s):  
Pat Arean ◽  
Eric Lenze ◽  
Joaquin A. Anguera
Keyword(s):  
Major Depression ◽  
Access To Care ◽  
Mood Disorders ◽  
Late Life ◽  
Later Life ◽  
Standardized Assessment ◽  
Younger Adults ◽  
Assessment Scores ◽  
Assessment And Treatment

This chapter discusses how clinicians will need to prepare for a worldwide exponentially growing aging community by describing the current scope of practices with respect to the assessment and treatment mood disorders, including minor and major depression. Particularly for those in later life, the meaningful interpretation of standardized assessment scores requires consideration of medical and neurological complexities. Clinicians must be flexible not only with respect to characterization, but especially with respect to treatment, given the inherent challenges associated with access to care and the range of disability amongst these individuals. Indeed, these late-life individuals are typically assessed in a similar fashion to younger adults (which may obscure meaningful interpretations), making understanding the nuances underlying existing behavioral and pharmaceutical approaches an essential endeavor.

Recent Advances in Late-Life Mood Disorders

2014 ◽  
Vol 3 (4) ◽  
pp. 245-252
Author(s):  
David A. Beck ◽  
Jacob A. Beck ◽  
Garrett Lambert
Keyword(s):  
Mood Disorders ◽  
Late Life ◽  
Recent Advances

scholarly journals 109 - Novel Treatments for Resistant Depression: Comparison of Older and Younger Patients

2020 ◽  
Vol 32 (S1) ◽  
pp. 21-21
Keyword(s):  
New York ◽  
Mood Disorders ◽  
Older Patients ◽  
Safety Data ◽  
Late Life ◽  
Response Rates ◽  
Younger Patients ◽  
Novel Treatments ◽  
Emory University ◽  
Resistant Depression

Treatment resistant depression (TRD) is defined as the failure to respond to two adequate antidepressant trials. TRD patients have high levels of psychosocial distress, poor levels of functioning and are at increased risk for suicide. Novel treatment approaches are being developed to address TRD involving both pharmacological and neuromodulation interventions. In this symposium, leaders in the field will outline three strategies for treating depression which has not responded to conventional therapy and contrast the efficacy of these strategies in younger vs. older patients. William McDonald MD (JB Fuqua Professor of Late -Life Depression, Emory University, Atlanta, GA) will provide a brief overview of TRD and moderate the discussion. George Petrides MD (Director of Clinical Trials Operation and Division of ECT, Zucker Hillside Hospital, New York, NY) will discuss recent data from the National Institute of Mental Health sponsored Consortium on ECT Research (CORE) outlining the response of older patients to ultrabrief right unilateral ECT in TRD. He will contrast the response to ECT in older vs, younger patients from the CORE database accumulated over the last 15 years. Collin Reiff MD (Addiction Psychiatrist, New York University Langone Health Center, NY, NY) will discuss his recent review in the American Journal of Psychiatry on Psychedelic and Psychedelic Assisted Psychotherapy and the implications on the treatment of medication resistant depression, including late life mood disorders. The FDA’s breakthrough designation of MDMA for the treatment of PTSD and psilocybin for the treatment of depression reflects the drugs’ potential to treat resistant psychiatric disorders. Psychedelic assisted therapy may play a unique role in late life mood disorders. Finally, Patricio Riva Posse MD (Director of the TRD and Ketamine Clinic, Emory University, Atlanta, GA) will discuss ketamine treatment in resistant depression including a comparison of response rates and safety data on ketamine treatment in older vs. younger patients. He has recently published the largest compilation of safety data for ketamine infusions and he will review a new tool to monitor safety in clinical practice. Dr. Riva Posse is medical director of the Emory TRD program and has enrolled over 1000 patients (100 in his IV ketamine clinic and about half over the age of 60 years) and followed patients through several novel treatments including transcranial magnetic stimulation, ketamine infusion therapy and ECT to start to look at differential response rates.

scholarly journals Translational Research in Late-Life Mood Disorders: Implications for Future Intervention and Prevention Research

2007 ◽  
Vol 32 (9) ◽  
pp. 1857-1875 ◽  
Author(s):  
Gwenn S Smith ◽  
Faith M Gunning-Dixon ◽  
Francis E Lotrich ◽  
Warren D Taylor ◽  
Jovier D Evans
Keyword(s):  
Translational Research ◽  
Mood Disorders ◽  
Late Life ◽  
Prevention Research

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.

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