Ect in the Medically Ill Elderly: A Case Report

2002 ◽  
Vol 32 (2) ◽  
pp. 209-213 ◽  
Author(s):  
Adekola O. Alao
Keyword(s):  
Case Report ◽  
Major Depression ◽  
Electroconvulsive Therapy ◽  
The Elderly ◽  
Medical Illness ◽  
Medical Problems ◽  
Medically Ill ◽  
History Of ◽  
Psychiatric Conditions ◽  
History Of Depression

Electroconvulsive therapy (ECT) is well recognized as an effective treatment for depression. However, it is not often used among the elderly due to increased co-morbid medical problems and fear of complications. We present here the case of an 88-year-old man with a history of depression and co-morbid medical illness. This patient was successfully treated with ECT. With the population of individuals above the age of 65 expected to double in the next 40 years, the use of ECT to treat major depression and other psychiatric conditions among the elderly will likely increase.

scholarly journals Is the Concept of Delirious Mania Valid in the Elderly? A Case Report and a Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Pramudith M. Maldeniya ◽  
Akshya Vasudev
Keyword(s):  
Case Report ◽  
Electroconvulsive Therapy ◽  
Classification System ◽  
The Elderly ◽  
Sudden Onset ◽  
Review Of The Literature ◽  
Clinical Assessments ◽  
Previous Diagnosis ◽  
Formal Classification ◽  
Psychotic Features

Delirious mania has been well recognized in the published literature and in the clinic. Over the years there has been refinement of understanding of its clinical features, course, and treatment. The literature suggests that delirious mania should be considered in individuals who present with a constellation of sudden onset delirium, mania, and psychosis. However, delirious mania is not recognized under a formal classification system nor are there any formal guidelines for its treatment. We, as such, question if the concept of delirious mania in the elderly is valid. We present a case of an elderly man with marked features of delirium with minimal manic or psychotic features who had a previous diagnosis of bipolar I disorder. On thorough clinical assessments no identifiable cause of his delirium was found. We therefore considered his presentation to be more likely due to delirious mania. Electroconvulsive therapy was considered and offered to which he responded very well. We invite the reader to consider whether delirious mania is a valid concept in the elderly, where features of delirium may be more prominent than manic or psychotic features.

Neuroticism may be associated with history of depression in the elderly

1991 ◽  
Vol 6 (7) ◽  
pp. 483-488 ◽  
Author(s):  
Robert C. Abrams ◽  
Robert C. Young ◽  
George S. Alexopoulos ◽  
Jonathan H. Holt
Keyword(s):  
The Elderly ◽  
History Of ◽  
History Of Depression

Electroconvulsive therapy versus transcranial magnetic stimulation for major depression: a review with recommendations for future research

2008 ◽  
Vol 20 (6) ◽  
pp. 291-294 ◽  
Author(s):  
Keith G. Rasmussen
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Major Depression ◽  
Electroconvulsive Therapy ◽  
Magnetic Stimulation ◽  
Large Scale ◽  
The Elderly ◽  
Future Research ◽  
Sample Sizes ◽  
Data Set ◽  
Differential Outcomes

Objective:To review the literature comparing electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) for major depression.Methods:Data from the six randomised, prospective studies were agglutinated into one data set. Special attention was given to the methods of both TMS and ECT as well as data pertaining to differential outcomes in subgroups such as psychotic depressives and the elderly.Results:There is a highly significant advantage for ECT in the prospective, randomised trials. The two non-randomised, retrospective comparative trials found the treatments to be equal in one study and superior for ECT in another. However, sample sizes are small in these studies, and both TMS and ECT may have been used suboptimally. Furthermore, the possibilities of differential efficacy of ECT or TMS for psychotic depressives or as a function of age have yet to be fully explored.Conclusions:The data to date do not support the contention that TMS is equivalent in efficacy to ECT. It is recommended that a large-scale trial be undertaken using aggressive forms of both TMS and ECT with sample sizes sufficiently large to detect effects of moderating variables such as age and psychosis status.

scholarly journals Relationship between progression of brain white matter changes and late-life depression: 3-year results from the LADIS study

2012 ◽  
Vol 201 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Michael J. Firbank ◽  
Andrew Teodorczuk ◽  
Wiesje M. Van Der Flier ◽  
Alida A. Gouw ◽  
Anders Wallin ◽  
...  
Keyword(s):  
White Matter ◽  
Depression Scale ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
White Matter Changes ◽  
Brain White Matter ◽  
History Of ◽  
Depressive Episodes ◽  
History Of Depression

BackgroundBrain white matter changes (WMC) and depressive symptoms are linked, but the directionality of this association remains unclear.AimsTo investigate the relationship between baseline and incident depression and progression of white matter changes.MethodIn a longitudinal multicentre pan-European study (Leukoaraiosis and Disability in the elderly, LADIS), participants aged over 64 underwent baseline magnetic resonance imaging (MRI) and clinical assessments. Repeat scans were obtained at 3 years. Depressive outcomes were assessed in terms of depressive episodes and the Geriatric Depression Scale (GDS). Progression of WMC was measured using the modified Rotterdam Progression scale.ResultsProgression of WMC was significantly associated with incident depression during year 3 of the study (P = 0.002) and remained significant after controlling for transition to disability, baseline WMC and baseline history of depression. There was no significant association between progression of WMC and GDS score, and no significant relationship between progression of WMC and history of depression at baseline.ConclusionsOur results support the vascular depression hypothesis and implicate WMC as causal in the pathogenesis of late-life depression.

scholarly journals Assessment of healthcare and placement needs in an older forensic psychiatric population in comparison to a younger forensic psychiatric population

2012 ◽  
Vol 24 (7) ◽  
pp. 1188-1190 ◽  
Author(s):  
Kavita Das ◽  
Kevin Murray ◽  
Rick Driscoll ◽  
S. Rao Nimmagadda
Keyword(s):  
Heart Disease ◽  
Neurological Disease ◽  
Older Patients ◽  
The Elderly ◽  
Healthcare Provision ◽  
Medical Problems ◽  
Older Offenders ◽  
History Of ◽  
Psychiatric Population ◽  
Forensic Psychiatric

The healthcare provision for the elderly with a history of offending is under-researched and suffers from a lack of adequate services. Although the number of offences committed by older patients is low, research suggests they are more likely to re-offend, and have significant legal and psychiatric histories (Tomar et al., 2005). Older offenders also have complex medical problems such as neurological disease, including dementia, heart disease, stroke, and hypertension (Lewis et al., 2006).

Antidepressant Medication May Moderate the Effect of Depression Duration on Hippocampus Volume

2016 ◽  
Vol 30 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Mark A. Rogers ◽  
Hidenori Yamasue ◽  
Kiyoto Kasai
Keyword(s):  
Major Depression ◽  
Antidepressant Treatment ◽  
Antidepressant Medication ◽  
Healthy Controls ◽  
Detailed History ◽  
Treatment History ◽  
Left Hippocampus ◽  
History Of ◽  
History Of Depression ◽  
Hippocampus Volume

Abstract. Hippocampus volume has been frequently, but not universally reported to be reduced in people with major depression relative to age-matched healthy controls. Among the potential reasons for this discrepancy in finding across studies is the effect of antidepressant medication. Hippocampus volume was determined by MRI (1.5 Tesla) for 10 people diagnosed with major depression for who detailed history of depression and antidepressant treatment history were known, and 10 age-matched healthy controls with no history of depression. Left, but not right, hippocampus volumes were significantly smaller in the patient group compared to the controls. Furthermore, there was a significant correlation such that left hippocampus volume was smaller with increasing lifetime duration of depression. However, this relationship was moderated by a significant correlation such that greater lifetime duration of antidepressant medication was associated with larger left hippocampus volume. The findings support the contention that antidepressant medication may act to normalize hippocampus volume.

Case Report: The Results of Reiki Practice in the Elderly with a History of Falls

Spatula DD ◽  
2012 ◽  
Vol 2 (3) ◽  
pp. 195
Author(s):  
Zeynep Erdogan ◽  
Sezgi Cinar
Keyword(s):  
Case Report ◽  
The Elderly ◽  
History Of

scholarly journals Altered Levels of Neurotrophic Factors in Alzheimer's Disease Patients with a Lifetimne History of Depression

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M.A. Rapp ◽  
V. Haroutunian ◽  
A. Heinz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Major Depression ◽  
Neurotrophic Factors ◽  
Major Depressive ◽  
Neurotrophin 3 ◽  
Co Morbidity ◽  
History Of ◽  
Underlying Mechanisms ◽  
History Of Depression

Aims:We have recently shown both increases in the number of neuropathological changes in Alzheimer's disease patients with a history of recurrent major depression, and evidence for Alzheimer's disease-related neuropathological changes in patients with geriatric major depression. However, the correlates and possible underlying mechanisms for these neuropathological changes in Alzheimer's disease patients as a function of depression remains to be studied.Method:Levels of several neurotrophic factors, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin-3 (NT-3) were measured in a sample of Alzheimer's disease patients with and without a lifetime history of major depressive disorder.Results:Alzheimer's disease patients with co-morbid depression showed lower levels BDNF (P < .001) and NGF (P < .001) than Alzheimer's disease patients without co-morbid depression. Results remained stable when controlling for age, gender, level of education, and other medical co-morbidities.Conclusion:In Alzheimer's disease, the presence of depression co-morbidity corresponds to decreases in neurotrophic factors beyond effects of age, education, and medical co-morbidities, suggesting that the previously described link between major depression and the neuropathological processes in Alzheimer's disease may be related to changes in neuronal survival mediated by neurotrophic factors.Funded by the National Institute on Aging (U01 AG016976 and NIA P01-AG05138) and NARSAD.

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