Concise Guide to Geriatric Psychiatry / Edition 3

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For the first time in history, most people in societies such as our own can plan on growing old. But longer average life expectancies (76.5 years in the United States) also bring increased risk. At least 12% of elderly Americans—and an astounding 30%--50% of those seen in primary care or hospitalized for medical conditions—have diagnosable mental disorders (e.g., cognitive impairment, affective and anxiety disorders).

Yet older people are poorly served by the mental health system, with its roadblocks of limited reimbursement and access, attitudes about aging, fewer psychotherapy referrals, and limited training in geriatric psychiatry. This third edition of a uniquely valuable pocket guide offers the latest research and practical advice for successfully diagnosing and treating elderly patients. The authors cover normal aging, mood and anxiety disorders, dementia, Alzheimer’s disease, delirium, common mental disorders, and competency and related forensic issues such as informed consent.

Clearly written and extensively illustrated, this informative guide also features an appendix of essential rating scales for depression, cognitive skills, and delirium. As such, it is a “must read” for all mental health professionals who work with the elderly and are challenged not only to identify and treat specific psychiatric disorders, but also to provide education, support, and preventive interventions to help older people and their families manage the common stresses of aging.

(From Dr. Spar)
Every section has been updated to reflect the contemporary literature, and there are new sections covering traumatic grief, vascular depression, strategies forantidepressant resistance, the genetics of Azheimer's disease, psychopharmacology of cognitive decline in Alzheimer's disease, frontotemporal and Lewy body dementia, and chronic pain. There is a new chapter on “Competency and Related Forensic Issues”, and the 3rd edition is over 40% thicker than the 2nd Edition.

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Editorial Reviews

Doody's Review Service
Reviewer: Robert M. McCarron, DO (Rush University Medical Center)
Description: This is simply a compact and practical resource used to care for geriatric patients who have psychiatric disorders.
Purpose: The primary purpose of this book is to provide an easy-to-read synopsis of geriatric psychiatry. The authors' objective is clearly met and the overall content is increasingly relevant and valuable as the number of people over the age of 65 in this country continues to rise.
Audience: Although the stated audience for this book is primarily students and psychiatrists, many other clinicians could benefit from its regular use. Specifically, primary care practitioners can use it as a reference and obtain information on forensic issues, dementia, delirium, and various mood disorders.
Features: The authors' frequent use of figures and tables commingled with a complete list of references and additional readings at the end of each chapter facilitate learning and encourages further exploration of the literature. Additionally, the coverage of delirium and dementia is particularly succinct and well written.
Assessment: This is a must-read reference for psychiatrists, primary care providers, consultation-liasion specialists, medicine residents, and nurses. It is an added bonus that this book not only effectively covers the basics of geriatric psychiatry but that it is small enough to be carried in the pocket.
From The Critics
This guide by Spar (psychiatry, UCLA School of Medicine) and La Rue (psychiatry, U. of New Mexico School of Medicine) provides practical information for psychiatrists, psychiatry residents, and medical students working in a variety of treatment settings. It is small enough to fit into a lab coat pocket or jacket pocket as a convenient source of information. Coverage includes normal aging, diagnosis and treatment of mood disorders, dementias and Alzheimer's disease, other dimentias and delirium, anxiety disorders, late-onset psychosis, other common mental disorders of the elderly, competency and related forensic issues, and clinical assessment instruments. Annotation c. Book News, Inc., Portland, OR (

4 Stars! from Doody
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Product Details

  • ISBN-13: 9781585620647
  • Publisher: American Psychiatric Publishing, Inc.
  • Publication date: 2/28/2002
  • Edition description: Third Edition
  • Edition number: 3
  • Pages: 376
  • Product dimensions: 4.48 (w) x 6.38 (h) x 0.81 (d)

Meet the Author

James E. Spar, M.D., is Professor of Psychiatry, Director of the Division of Geriatric Psychiatry, and Director of Residency Education in the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles, School of Medicine.

Asenath La Rue, Ph.D., is Professor of Psychiatry at the University of New Mexico School of Medicine.

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Table of Contents

Introduction to the Concise Guides Series
1 Introduction 1
Contemporary Aging and Health Care 1
Mental Disorders in Later Life 7
Barriers to Geriatric Mental Health Care 9
Diversity in Patterns of Health and Aging 12
Working Effectively With Older Patients 14
2 Normal Aging 19
Conceptual Issues 19
Cognitive Abilities in Later Life: A Processing Resource Model 21
Personality and Emotional Changes 34
The Social Context of Aging 39
Biological Aging 45
3 Mood Disorders - Diagnosis 61
Major Depression 62
Normal Grief (Bereavement) 85
Traumatic Grief 86
Substance-Induced Depression 87
Depression Due to a General Medical Condition 90
Dysthymic Disorder 93
Minor Depression 94
Characterologic Depression 95
Suicidality 95
Bipolar Mood Disorder 98
4 Mood Disorders - Treatment 111
Psychosocial Treatment of Depression 111
Psychopharmacotherapy of Nonpsychotic Depression 115
Psychopharmacotherapy of Psychotic Depression 142
Electroconvulsive Therapy 143
Complementary and Alternative Theapies 145
Bipolar Mood Disorder 146
5 The Dementias and Alzheimer's Disease 153
Identifying the Dementia Syndrome 153
Common Etiologies of Dementia 166
Alzheimer's Disease 166
6 Other Dementias and Delirium 197
Frontotemporal Dementia 197
Dementia With Lewy Bodies 201
Vascular Dementia 206
Other Dementias 214
Dementia Due to Other General Medical Conditions 218
Substance-Induced Persisting Dementia 219
Reversible Dementia 219
Delirium 220
7 Anxiety Disorders 233
Epidemiology 233
Clinical Presentation 234
Differential Diagnosis of Anxiety Disorders 234
Pathogenesis 241
Laboratory Evaluation 243
Anxiety Rating Scales 245
Treatment 245
8 Late-Onset Psychosis 253
Epidemiology 253
Diagnostic Criteria 254
Clinical Presentation 254
Pathogenesis 256
Differential Diagnosis 258
Treatment 259
9 Other Common Mental Disorders of the Elderly 267
Insomnia 267
Substance Abuse 274
Sexual Dysfunction 281
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