The psychotic illness, for example schizophrenia or delusional disorder, may already have started at a young age.If schizophrenia has its onset in the middle or old age only, the term ’late-onset (or very-late-onset) schizophrenia-like psychosis’ is used.Psychotic symptoms may occur in association with a number of organic and psychiatric conditions.Depression, mania and deliriumMetabolic and endocrinological disordersNeurological diseases Memory diseaseCNS infectionsMedication, poisonings and drug overdosesWhen medication is started, the lowest possible dose is sought to avoid adverse effects.
Across the spectrum of psychopathology in later life, psychotic symptomatology has been the most neglected, and although literature in this area is increasing, this is the first book to address the need for an overarching framework to examine and understand late-life psychotic phenomena. Exploring the practical and ethical issues that arise when ma
Thoroughly updated for its Fourth Edition, this volume is the most authoritative clinical reference on the pharmacologic treatment of psychiatric disorders in elderly patients. This edition provides complete information on new psychotropic drugs, new uses for established drugs, and clinically relevant advances in the neurosciences. Four new chapters cover genes, pharmacokinetics, and their impact on prescribing; new cognitive-enhancing strategies and drugs; late-life depression and physical illness; and depression and cardiac disease in late life. The book offers detailed guidelines—including drug names, dosages, and prescribing recommendations—for pharmacologic treatment of specific disorders. Chapters include clinical vignettes and tables presenting current clinical trial data. Appendices provide succinct information on prescribing and drug interactions.
Introduction:Psychosis and dementia has been reported extensively in elderly patients. Psychotic symptoms are present in over 50% of Alzheimer's patients during the course of this progressive illness, and some authors have reported rates of behavioral disturbance up to 70%. Methods:We present a case study of a 73-year-old woman, which was hospitalized due to behavioral disturbances related to the fact that, as reported by herself, she had been raising up a child (which was actually a child size baby Jesus) as her motheru00b4s child, whom had passed away more than 20 years ago, and upon her deathbed, had told her to take care of this child.The patient had lost its complete perception of reality, and had clear onset symptoms of Alzheimeru2019s type dementia. Nevertheless, she had a calm state of mind, and was hopeful to carry out her motheru00b4s task. The patient was unmarried and hadnu2019t been able to conceive in her lifetime. This delusional symptom had initiated around a year ago.Results:After our exam, we decided to release this woman without any antipsychotic medication, due to the fact that, this patient had developed a clear relationship with its doll, she had finally developed her motherhood desires, and had an ongoing degenerative disease which was rapidly advancing.Conclusions:Elderly patients presenting with psychotic symptoms require social, behavioral, and environmental interventions that are necessary for their safety and reorientation. Given the likelihood of comorbid medical disorders and concomitant medications, the mere presence of delusions or hallucinations is not always an indication for additional medications.
Introduction:Psychosis and dementia has been reported extensively in elderly patients. Psychotic symptoms are present in over 50% of Alzheimer's patients during the course of this progressive illness, and some authors have reported rates of behavioral disturbance up to 70%. Methods:We present a case study of a 73-year-old woman, which was hospitalized due to behavioral disturbances related to the fact that, as reported by herself, she had been raising up a child (which was actually a child size baby Jesus) as her motheru00b4s child, whom had passed away more than 20 years ago, and upon her deathbed, had told her to take care of this child.The patient had lost its complete perception of reality, and had clear onset symptoms of Alzheimeru2019s type dementia. Nevertheless, she had a calm state of mind, and was hopeful to carry out her motheru00b4s task. The patient was unmarried and hadnu2019t been able to conceive in her lifetime. This delusional symptom had initiated around a year ago.Results:After our exam, we decided to release this woman without any antipsychotic medication, due to the fact that, this patient had developed a clear relationship with its doll, she had finally developed her motherhood desires, and had an ongoing degenerative disease which was rapidly advancing.Conclusions:Elderly patients presenting with psychotic symptoms require social, behavioral, and environmental interventions that are necessary for their safety and reorientation. Given the likelihood of comorbid medical disorders and concomitant medications, the mere presence of delusions or hallucinations is not always an indication for additional medications.
This case series book offers a practical and accessible approach to psychiatry, addressing major clinical problems ranging from psychosis to aging effects, each of which is tackled as it arises in everyday settings. With its emphasis on everyday practice strongly linked to underlying theory, the book combines clinical knowledge with the realities of managing clinical problems, and will provide a basis for developing sound analytical and confident decision-making skills. Presenting different visions of clinical psychiatry and expanding psychiatrists' interventions by integrating innovative neuroscience approaches such as neuroimaging, neuropsychology, TMS and cognitive rehabilitation, it will help clinicians and students alike gain a sound understanding of the wide range of signs and symptoms that indicate psychiatric disorders, and how the diagnosis, management and treatment options can differ from those in other medical specialties. The volume includes learning activities, with questions on each clinical case followed by detailed explanatory answers, and self-assessment exercises to assist with learning and revision. Throughout the book, tips and key features are highlighted with boxes, algorithms, tables and figures, which the reader can refer back to for exam revision and well into her/his career.
This manual attempts to provide simple, adequate and evidence-based information to health care professionals in primary health care especially in low- and middle-income countries to be able to provide pharmacological treatment to persons with mental disorders. The manual contains basic principles of prescribing followed by chapters on medicines used in psychotic disorders; depressive disorders; bipolar disorders; generalized anxiety and sleep disorders; obsessive compulsive disorders and panic attacks; and alcohol and opioid dependence. The annexes provide information on evidence retrieval, assessment and synthesis and the peer view process.
This book is a practical resource that will support the delivery of holistic mental health interventions in the primary and community care setting for older people. Primary care delivery is discussed in relation to both functional mental health problems, such as anxiety, depression, and psychotic and personality disorders, and acquired organic mental disorders of old age, such as dementia, cognitive impairments, and delirium. Careful consideration is paid to the complex relationship between mental and somatic health problems, as well as the impacts of multimorbidity and polypharmacy. Further topics include, for example, epidemiology, wider determinants of health, different care models, history taking, neurocognitive and capacity assessment, and pharmacological, psychological, and physical interventions. The wider goals of the book are to support the development of community resilience and self-care in older people; to promote universal access and equity for older people in order to enable them to achieve or recover the highest attainable standard of health, regardless of age, gender, or social position; and to promote pathways to care for older people with mental health problems respecting their autonomy, independence, human rights, and the importance of the life-course approach. This book will be an invaluable resource for all professionals who work with older adults with mental health problems and those training in these fields including physicians, psychiatrists, family doctors, geriatricians, general practitioners, nurses, psychologists, neurologists, occupational therapists, social workers, support workers and community health and social care workers.
This unique manual presents cognitive-behavioral social skills training (CBSST), a step-by-step, empirically supported intervention that helps clients with schizophrenia achieve recovery goals related to living, learning, working, and socializing. CBSST interweaves three evidence-based practices--cognitive-behavioral therapy, social skills training, and problem-solving training--and can be delivered in individual or group contexts. Highly user friendly, the manual includes provider scripts, teaching tools, and engaging exercises and activities. Reproducible consumer workbooks for each module include skills summaries and worksheets. The large-size format facilitates photocopying; purchasers also get access to a Web page where they can download and print the reproducible materials. Listed in SAMHSA's National Registry of Evidence-Based Programs and Practices
