Most physical illness affects people at the extremes of life, particularly in late life. A significant proportion of hospitalized older patients will experience some mental health problems, and medical units lacking specialist old age psychiatric services must rely on adult psychiatric and consultation liaison services for support. These generalists assume the role of old age psychiatrists by default. A key aim of the book is to provide guidelines for the appropriate treatment of psychiatric disorders in older people when medical illness complicates the picture. The book is divided into five sections. The first two sections cover the nature of the problem and initial assessment procedures. Section three focuses on specific disorders, including, amongst others, the most common reasons for referral - dementia, depression and delirium. Section four provides guidelines for treatment including pharmacological therapies, psychotherapeutic interventions and the use of ECT. The book concludes with a short section considering the ethical and legal issues involved. This book covers the theoretical and practical knowledge required by psychiatrists in training, those seeking to specialize in consultation liaison or old age psychiatry, geriatricians and general practitioners. It will also be of interest to all other members of the healthcare team responsible for the medical management of older patients. Table of Contents: Section One - The Context 1. Geriatric consultation liaison psychiatry, Draper 2. The effects of ageing, Melding 3. Coping with illness in late life, Melding & Cook 4. The geriatrician's perspective of consultation liaison psychiatry, Wood Section Two - Assessment 5. The assessment, Draper & Melding Section Three - The Major Disorders 6. Affective disorders, Evans & Moltram 7. Anxiety, Flint 8. Somatoform disorders in late life, Melding & Armstrong 9. Psychosis and medical illness, Almeida 10. Organic mental disorders, Taylor & Shah 11. Specific patients and problems, Shah & Ames Section Four - Treatment 12. Psychopharmacological management of the medically ill older person, Flint 13. ECT in older patients with physical illness, Tew, Mulsant & Towers 14. Non-biological therapies, Wilson & Payne Section Five - Ethical and Legal Issues 15. Ethical issues in geriatric psychiatry liaison, Perkins 16. A legal perspective on issues in geriatric liaison psychiatry, Bouchier Contributors: Dr Osvaldo Almeida, Dept of Psychiatry & Behavioural Science, University of Western Australia Professor David Ames, Dept of Psychiatry, University of Melbourne, Australia Dr Louise Armstrong, Auckland, New Zealand Ms Hanneke Bouchier, Auckland, New Zealand Dr Andrew J Cook, Division of Pain Management, University of Virginia Health System, Charlottesville, USA Dr Brian Draper, Prince of Wales Hospital, New South Wales, Australia Dr Mavis Evans, Clatterbridge Hospital, Wirral, UK Professor Alistair Flint, Toronto General Hospital, Ontario, Canada Dr Pamela Melding, Division of Psychiatry & Behavioural University of Auckland, New Zealand Dr Patricia Mottram, Liverpool, UK Dr Benoit Mulsant, University of Pittsburgh School of Medicine, USA Dr Julia Payne, University of Liverpool, UK Dr Christine Perkins, Consultant in Psychiatry of Old Age, New Zealand Dr Ajit Shah, Imperial College School of Medicine, London, UK Dr David Taylor, Hammersmith & Fulham NHS Trust, London, UK Dr James Tew, University of Pittsburgh School of Medicine, USA Dr Adele Towers, University of Pittsburgh School of Medicine, USA Professor Ken Wilson, University of Liverpool, UK Dr Philip Wood, Consultant in Geriatric Medicine, New Zealand |