The Old Age Psychiatry Handbook: A Practical Guide

The Old Age Psychiatry Handbook......Page 4
Contents......Page 10
Preface......Page 14
Acknowledgements......Page 16
Introduction......Page 18
Setting......Page 19
The psychiatric history in older patients......Page 22
The Mental State Examination (MSE)......Page 27
Assessing cognition with limited time......Page 34
Investigations......Page 35
Neuropsychiatric testing and the memory clinic......Page 37
Summary......Page 38
Further reading......Page 39
2 Dementia......Page 40
Definition and diagnosis of dementia......Page 42
General management of dementia......Page 43
Behavioural and psychological symptoms of dementia......Page 45
Why differentiate between the dementias?......Page 48
Alzheimer’s disease......Page 50
Vascular dementia......Page 58
Dementia with Lewy bodies......Page 63
Less common causes of dementia......Page 67
Mild cognitive impairment......Page 72
Functional and molecular neuroimaging in dementia......Page 73
Further reading......Page 74
Epidemiology......Page 76
Clinical features and diagnosis......Page 77
Risk factors for depression in old age......Page 79
Treatment......Page 84
Prevention of depression in the elderly......Page 88
Depression and dementia......Page 89
Bereavement......Page 90
Suicide......Page 92
Further reading......Page 95
Epidemiology......Page 98
Clinical features and diagnosis......Page 99
Management......Page 103
Anxiety in the elderly......Page 108
Generalised anxiety disorder......Page 111
Panic disorder......Page 113
Phobic disorders......Page 114
Post-traumatic stress disorder......Page 118
Other reactions to stress......Page 120
Obsessive compulsive disorder......Page 122
Further reading......Page 125
Schizophrenia......Page 126
Schizoaffective disorder......Page 135
Delusional disorder......Page 136
Further reading......Page 138
Personality......Page 140
Personality and age......Page 141
Personality disorders in old age......Page 142
Management of personality disorder in old age......Page 146
Further reading......Page 147
Current guidelines for alcohol consumption......Page 148
Definitions......Page 149
Detection and screening......Page 150
Consequences......Page 152
Management......Page 156
Further reading......Page 158
Sleep architecture......Page 160
Causes of insomnia......Page 162
Assessment of a patient with insomnia......Page 163
Pharmacological management......Page 164
Further reading......Page 165
Principles of drug treatment in old age psychiatry......Page 166
Adherence......Page 167
Pharmacokinetics and pharmacodynamics......Page 170
Adverse drug reactions and interactions......Page 175
Antidepressant drugs......Page 179
Lithium......Page 197
Anticonvulsant mood stabilisers......Page 201
Antipsychotic drugs......Page 204
Anxiolytics and hypnotics......Page 211
Drugs used in dementia......Page 216
Further reading......Page 221
11 Electroconvulsive Therapy......Page 222
Mechanism of action......Page 223
Adverse effects......Page 224
Pre-ECT physical work-up......Page 225
ECT procedure......Page 226
Further reading......Page 228
Cognitive behavioural therapy......Page 230
Behavioural therapy......Page 233
Psychoanalytic psychotherapy......Page 234
Interpersonal psychotherapy......Page 235
Further reading......Page 236
13 Practical, Legal and Social Issues......Page 238
Provision of services......Page 239
Legal issues in old age psychiatry......Page 242
Social and financial issues in old age......Page 255
Further reading......Page 259
14 Physical Illness and Old Age Psychiatry......Page 260
Delirium......Page 261
Vascular disease......Page 270
Neurological disease......Page 275
Rheumatological disease......Page 284
Endocrinological disease......Page 286
Nutritional deficit......Page 292
Neoplastic disease......Page 293
Palliative care......Page 294
Further reading......Page 298
Appendices......Page 300
Index......Page 310