We live in an aging world. Illnesses that are prevalent and cause significant morbidity and mortality in older people will consume an increasing share of health care resources. One such illness is depression. This illness has a particularly devastating impact in the elderly because it is often
undiagnosed or inadequately treated. Depression not only has a profound impact on quality of life but it is associated with an increased risk of mortality from suicide and vascular disease. In fact for every medical illness studied, e.g. heart disease, diabetes, cancer, individuals who are depressed
have a worse prognosis. Research has illuminated the physiological and behavioral effects of depression that accounts for these poor outcomes. The deleterious relationship between depression and other illnesses has changed the concept of late-life depression from a "psychiatric disorder" that is
diagnosed and treated by a psychiatrist to a common and serious disorder that is the responsibility of all physicians who care for patients over the age of 60.
This is the first volume devoted to the epidemiology, phenomenology, psychobiology, treatment and consequences of late-life depression. Although much has been written about depressive disorders, the focus has been primarily on the illness as experienced in younger adults. The effects of aging on the
brain, the physiological and behavioral consequences of recurrent depression, and the impact of other diseases common in the elderly, make late-life depression a distinct entity. There is a compelling need for a separate research program, specialized treatments, and a book dedicated to this
disorder. This book will be invaluable topsychiatrists, gerontologists, clinical psychologists, social workers, students, trainees, and others who care for individuals over the age of sixty.
We live in an aging world. Illnesses that are prevalent and cause significant morbidity and mortality in older people will consume an increasing share of health care resources. One such illness is depression. This illness has a particularly devastating impact in the elderly because it is often
undiagnosed or inadequately treated. Depression not only has a profound impact on quality of life but it is associated with an increased risk of mortality from suicide and vascular disease. In fact for every medical illness studied, e.g. heart disease, diabetes, cancer, individuals who are depressed
have a worse prognosis. Research has illuminated the physiological and behavioral effects of depression that accounts for these poor outcomes. The deleterious relationship between depression and other illnesses has changed the concept of late-life depression from a "psychiatric disorder" that is
diagnosed and treated by a psychiatrist to a common and serious disorder that is the responsibility of all physicians who care for patients over the age of 60.
This is the first volume devoted to the epidemiology, phenomenology, psychobiology, treatment and consequences of late-life depression. Although much has been written about depressive disorders, the focus has been primarily on the illness as experienced in younger adults. The effects of aging on the
brain, the physiological and behavioral consequences of recurrent depression, and the impact of other diseases common in the elderly, make late-life depression a distinct entity. There is a compelling need for a separate research program, specialized treatments, and a book dedicated to this
disorder. This book will be invaluable topsychiatrists, gerontologists, clinical psychologists, social workers, students, trainees, and others who care for individuals over the age of sixty.
Introduction
PART I EPIDEMIOLOGY AND THE BURDEN OF ILLNESS
1: Dan G. Blazer: The Epidemiology of Depressive Disorders in Late
Life
2: Barry D. Lebowitz and Jason T. Olin: The Social and Financial
Burden of Late-Life Depression to Society and Individuals
PART II THE PHENOMENOLOGY AND DIFFERENTIAL DIAGNOSIS OF LATE-LIFE
MOOD DISORDERS
3: George S. Alexopoulos and William Apfeldorf: Unipolar
Depression
4: Robert C. Young: Bipolar Disorders
5: D.P. Devanand: Dysthymic Disorder in the Elderly
6: Anand Kumar, Helen Lavretsky, and Virginia Elderkin-Thompson:
Non-Major Clinically Significant Depression in the Elderly
7: Helen Lavretsky and Gary W. Small: Mixed Cognitive and
Depressive Syndromes
8: Yeates Conwell: Suicide
9: Paula J. Clayton: Bereavement and Depression
PART III THE PSYCHOBIOLOGY OF LATE-LIFE DEPRESSION
10: Wilfred G. van Gorp, James C. Root, and Harold A. Sackeim:
Neuropsychological Assessment of Late-Life Depression
11: Structural and Functional Brain Imaging in Late-Life Depression
Harold A. Sackeim
12: K.R. Ranga Krishnan: Late-Life Depression and the Vascular
Hypothesis
13: Jennifer Keller, Theresa M. Buckley, and Alan F. Schatzberg:
Hypothalmic-Pituitary-Adrenal Axis Activity in Mood and Cognition
in the Elderly: Implications for Symptoms and Outcomes
14: Stuart N. Seidman: The Neuroendocrinology of Aging
PART IV TREATMENT
15: Bruce G. Pollock: Pharmacokinetics and Pharmacodynamics in Late
Life
16: Steven P. Roose and Harold A. Sackeim: Antidepressant
Medication for the Treatment of Late Life Depression
17: Carl Salzman: Antidepressant Side Effects
18: Charles L. Bowden and Nancy U. Karren: Mood Stabilizers
19: J. Craig Nelson and Leon J. Epstein: Stimulants
20: Christian R. Dolder, Jonathan P. Lacro, and Dilip V. Jeste:
Antipsychotics
21: Harold A. Sackeim: Electroconvulsive Therapy in Late-Life
Depression
22: John L. Beyer and P. Murali Doraiswamy: Pharmacologic Treatment
of Depression in Alzheimer's Disease
23: Charles F. Reynolds III, Patricia A. Arean, Thomas R. Lynch,
and Ellen Frank: Psychotherapy in Old-Age Depression: Progress and
Challenges
24: Ira R. Katz and Joel Streim: Treatment of Depression in
Residential Settings
PART V. DEPRESSION CO-MORBID WITH OTHER ILLNESSES
25: Steven P. Roose and Alexander H. Glassman: Depression co-Morbid
with Ischemic Heart Disease
26: Robert G. Robinson: Vascular Disease and Late-Life Depression:
Stroke
27: David W. Oslin: Substance Abuse and Co-Morbidity
28: Anjan Chatterjee and Karen Marder: Basal Ganglia Disease and
Depression
29: George S. Zubenko: Major Depressive Disorder in Alzheimer's
Disease
This is an important book. it will become the standard reference book for all major topics under the rubric of late-life depression. International Journal of Geriatric Psychiatry, Vol 20 An outstanding 388-page textbook dedicated to the subject of depression in the elderly. What is remarkable about this book is that it strives to use an evidence-based approach to describe illness models and clinical treatments ... an excellent textbook that can be used as a clinical resource, a study aid for the boards, or a review of the evidence-based research in late-life depression. Journal of Clinical Psychiatry This book is "state of the art" ... The editors have brought together many of the leading researchers in the field to assemble an authoritative reference that will be useful for students, residents, practicing physicians, and mental health professionals in related fields. For a multiauthored textbook, Late-Life Depression is well organized, appropriately succinct, and clear. Those qualities in themselves are accomplishments. The great strength of the book is its medical and biologic orientation ... It will serve as an excellent resource for those seeking to understand the clinical varieties of the condition, relevant pathobiologic theories and correlates, and approaches to treatment. New England Journal of Medicine
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