The Old Age Psychiatry Handbook: A Practical Guide

Acknowledgements.

1 The Assessment of Patients in Old Age Psychiatry.

Introduction.

Setting.

The psychiatric history in older patients.

The Mental State Examination (MSE). 

Assessing cognition with limited time.

Assessment of everyday functioning.

Physical examination.

Investigations.

Neuropsychiatric testing and the memory clinic.

Assessment of carers.

Summary.

Further reading.

2 Dementia.

Definition and diagnosis of dementia.

Assessment of a patient with dementia.

General management of dementia.

Behavioural and psychological symptoms of dementia.

Why differentiate between the dementias?

Alzheimer’s disease.

Vascular dementia.

Dementia with Lewy bodies.

Frontotemporal dementia.

Less common causes of dementia.

Mild cognitive impairment.

Functional and molecular neuroimaging in dementia.

Further reading.

3 Depression.

Epidemiology.

Clinical features and diagnosis.

Risk factors for depression in old age.

Treatment.

Outcome.

Prevention of depression in the elderly.

Depression and dementia.

Bereavement.

Suicide.

Further reading.

4 Bipolar Affective Disorder.

Epidemiology.

Aetiology.

Clinical features and diagnosis.

Management.

5 Anxiety Disorders and Obsessive Compulsive Disorder.

Anxiety in the elderly.

Generalised anxiety disorder.

Panic disorder.

Phobic disorders.

Post-traumatic stress disorder.

Other reactions to stress.

Obsessive compulsive disorder.

Further reading.

6 Psychotic Illness.

Schizophrenia.

Schizoaffective disorder.

Delusional disorder.

Further reading.

7 Personality Disorders.

Personality.

Personality and age.

Definition and classification of personality disorders.

Personality disorders in old age.

Management of personality disorder in old age.

Further reading.

8 Alcohol.

Current guidelines for alcohol consumption.

Definitions.

Epidemiology.

Detection and screening.

Consequences.

Management.

Further reading.

9 Insomnia.

Sleep architecture.

Circadian rhythm.

Insomnia and consequences in the elderly.

Causes of insomnia.

Assessment of a patient with insomnia.

Non-pharmacological management.

Pharmacological management.

Further reading.

10 Psychopharmacology.

Principles of drug treatment in old age psychiatry.

Adherence.

Pharmacokinetics and pharmacodynamics.

Adverse drug reactions and interactions.

Antidepressant drugs.

Lithium.

Anticonvulsant mood stabilisers.

Antipsychotic drugs.

Anxiolytics and hypnotics.

Drugs used in dementia.

Further reading.

11 Electroconvulsive Therapy.

Indications.

Mechanism of action.

Efficacy.

Adverse effects.

Cautions.

Consent.

ECT and the Mental Health Act.

Pre-ECT physical work-up.

Medication and ECT.

ECT procedure.

Prevention of relapse.

Further reading.

12 Psychological Therapies.

Cognitive behavioural therapy.

Behavioural therapy.

Psychoanalytic psychotherapy.

Further reading.

13 Practical, Legal and Social Issues.

Provision of services.

Legal issues in old age psychiatry.

Social and financial issues in old age.

Further reading.

14 Physical Illness and Old Age Psychiatry.

Delirium.

Vascular disease.

Neurological disease.

Rheumatological disease.

Endocrinological disease.

Nutritional deficit.

Neoplastic disease.

Palliative care.

Further reading.

Appendices.

Index.