By Robert Baldwin

Melancholy impacts among 10-15% of older humans, making it the main often encountered psychological well-being situation in later lifestyles. regardless of this, the is definitely neglected in medical perform or no longer accurately treated.

Part of the Oxford Psychiatry Library, this concise pocketbook presents an available account of what melancholy in older humans is like, why it will be important, and what remedies aid. The textual content highlights which components of melancholy are of targeted relevance to later lifestyles, the best way to diagnose melancholy in an older individual, the overlap with dementia and numerous different actual health problems, and demanding pharmacological issues.

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This can be undertaken by using the Mini-Mental State Examination (MMSE) (Folstein et al. 1975) or the briefer 6-item Orientation Memory-Concentration (OMC) (Brooke and Bullock 1999) (see also Chapter 7). A physical examination focused on clues from the history should be carried out; for example, neurological examination in Assessment and management CHAPTER 6 patients complaining of cognitive impairment. 2) should include haemoglobin and red blood cell counts, which may point to B12 deficiency or alcohol misuse.

British Medical Journal, 312, 947. Bench CJ, Friston KJ, Brown RG, Scott LC, Frackowiak RSJ, Dolan RJ (1992). The anatomy of depression - focal abnormalities of cerebral blood flow in major depression. Psychological Medicine, 22, 607–15. Blazer DG (2003). Depression in late life: review and commentary. Journal of Gerontology: Medical Sciences, 58A, 249–65. Blazer DG II and Hybels CF (2005). Origin of depression in later life. Psychological Medicine, 35, 1241–52. Cole MG and Dendukuri N (2003). Risk factors for elderly community subjects: a systematic review and meta-analysis.

1992). It is now recognized that distributed neuronal networks and not just single pathways or neurochemicals are important in depression. Tekin and Cummings (2002) have suggested that superior limbic structures may regulate attention and cognitive aspects of depression (apathy, psychomotor disturbance, impaired attention, and dysexecutive symptoms); a ventral compartment formed of limbic, paralimbic, and subcortical structures may mediate vegetative and somatic aspects (sleep, appetite, endocrine disturbance); and the rostral cingulate area may regulate interactions between these two.

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