Late-Life Depression

Edited by Steven P. Roose, M.D. and Harold A. Sackeim

Society is aging and illnesses that are prevalent and devastating in older individuals will consume an increasingly greater share of our health care resources. Depression is a devastating illness in the elderly that results in deterioration in quality of life and an increase in mortality from suicide and vascular disease. This is the first volume devoted exclusively to an understanding of the diagnosis and treatment of this disorder. Leading researchers and clinicians contribute chapters on the epidemiology, phenomenology, physiology, treatment, and long-term outcome of late-life depression. This book was designed to be accessible and useful to clinicians, researchers, educators, and students in psychiatry, gerontology, clinical psychology, and social work.

Late-Life Depression

Edited by Steven P. Roose, M.D. and Harold A. Sackeim

Description

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 to psychiatrists, gerontologists, clinical psychologists, social workers, students, trainees, and others who care for individuals over the age of sixty.

Late-Life Depression

Edited by Steven P. Roose, M.D. and Harold A. Sackeim

Introduction
PART I EPIDEMIOLOGY AND THE BURDEN OF ILLNESS
1. The Epidemiology of Depressive Disorders in Late Life, Dan G. Blazer
2. The Social and Financial Burden of Late-Life Depression to Society and Individuals, Barry D. Lebowitz and Jason T. Olin
PART II THE PHENOMENOLOGY AND DIFFERENTIAL DIAGNOSIS OF LATE-LIFE MOOD DISORDERS
3. Unipolar Depression, George S. Alexopoulos and William Apfeldorf
4. Bipolar Disorders, Robert C. Young
5. Dysthymic Disorder in the Elderly, D.P. Devanand
6. Non-Major Clinically Significant Depression in the Elderly, Anand Kumar, Helen Lavretsky, and Virginia Elderkin-Thompson
7. Mixed Cognitive and Depressive Syndromes, Helen Lavretsky and Gary W. Small
8. Suicide, Yeates Conwell
9. Bereavement and Depression, Paula J. Clayton
PART III THE PSYCHOBIOLOGY OF LATE-LIFE DEPRESSION
10. Neuropsychological Assessment of Late-Life Depression, Wilfred G. van Gorp, James C. Root, and Harold A. Sackeim
11. Structural and Functional Brain Imaging in Late-Life Depression Harold A. Sackeim
12. Late-Life Depression and the Vascular Hypothesis, K.R. Ranga Krishnan
13. Hypothalmic-Pituitary-Adrenal Axis Activity in Mood and Cognition in the Elderly: Implications for Symptoms and Outcomes, Jennifer Keller, Theresa M. Buckley, and Alan F. Schatzberg
14. The Neuroendocrinology of Aging, Stuart N. Seidman
PART IV TREATMENT
15. Pharmacokinetics and Pharmacodynamics in Late Life, Bruce G. Pollock
16. Antidepressant Medication for the Treatment of Late Life Depression, Steven P. Roose and Harold A. Sackeim
17. Antidepressant Side Effects, Carl Salzman
18. Mood Stabilizers, Charles L. Bowden and Nancy U. Karren
19. Stimulants, J. Craig Nelson and Leon J. Epstein
20. Antipsychotics, Christian R. Dolder, Jonathan P. Lacro, and Dilip V. Jeste
21. Electroconvulsive Therapy in Late-Life Depression, Harold A. Sackeim
22. Pharmacologic Treatment of Depression in Alzheimer's Disease, John L. Beyer and P. Murali Doraiswamy
23. Psychotherapy in Old-Age Depression: Progress and Challenges, Charles F. Reynolds III, Patricia A. Arean, Thomas R. Lynch, and Ellen Frank
24. Treatment of Depression in Residential Settings, Ira R. Katz and Joel Streim
PART V. DEPRESSION CO-MORBID WITH OTHER ILLNESSES
25. Depression co-Morbid with Ischemic Heart Disease, Steven P. Roose and Alexander H. Glassman
26. Vascular Disease and Late-Life Depression: Stroke, Robert G. Robinson
27. Substance Abuse and Co-Morbidity, David W. Oslin
28. Basal Ganglia Disease and Depression, Anjan Chatterjee and Karen Marder
29. Major Depressive Disorder in Alzheimer's Disease, George S. Zubenko

Late-Life Depression

Edited by Steven P. Roose, M.D. and Harold A. Sackeim

Reviews and Awards

"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." --The New England Journal of Medicine

"...full of lively and expert discussion on a topic that is of interest not only to specialists in geriatric mental health, but also to generalist health professionals and academics who care for and study our increasingly aged population."--The Journal of Nervous and Mental Disease

"...an up-to-date book that helps illuminate the deleterious relationship between depression in late life and other illnesses."--Psychiatric Services

"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