Abstract
Changes in behavior and thought process are a common clinical conundrum in home-based medicine. Depression in older adults is under-recognized and undertreated. Depression with psychotic features is more severe than depression without psychotic features and often results in prolonged incapacity and an increased likelihood of recurrence. First-line treatment should include an antidepressant and antipsychotic given concomitantly or electroconvulsive therapy (ECT).
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Reinhardt MM, Cohen CI. Late-life psychosis: diagnosis and treatment. Curr Psychiatry Rep. 2015;17(2):1.
Fiske A, Wetherell JL, Gatz M. Depression in older adults. Annu Rev Clin Psychol. 2009;5:363–89.
Wijkstra J, Lijmer J, Burger H, et al. Pharmacological treatment for psychotic depression. Cochrane Database of Syst Rev. 2015;7:CD004044.
Wagner GS, McClintock SM, Rosenquist PB, McCall WV. Major depressive disorder with psychotic features may lead to misdiagnosis of dementia: a case report and review of the literature. J Psychiatr Pract. 2011;17(6):432–8.
Birrer RB, Vemuri SP. Depression in later life: a diagnostic and therapeutic challenge. Am Fam Physician. 2004;69:2375–82.
Alexopoulos GS, Streim J, Carpenter D, Docherty JP. Expert consensus panel for using antipsychotic drugs in older patients. Using antipsychotic agents in older patients. J Clin Psychiatry. 2004;65(Suppl 2):5–99.
Meyers BS, Flint AJ, Rothschild AJ, et al; STOP-PD Group. A double-blind randomized controlled trial of olanzapine plus sertraline vs olanzapine plus placebo for psychotic depression: the study of pharmacotherapy of psychotic depression (STOP-PD). Arch Gen Psychiatry. 2009;66(8):838–47.
Solomon CGE, Taylor WD. Depression in the elderly. N Engl J Med. 2014;371:1228–36.
Muench J, Hamer AM. Adverse effects of antipsychotics medications. Am Fam Physician. 2010;81(5):617–22.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Bhatia, S., Kopke, M.V.M. (2020). Serious Mental Illness. In: Colburn, J., Leff, B., Hayashi, J., Schuchman, M. (eds) Home-Based Medical Care for Older Adults. Springer, Cham. https://doi.org/10.1007/978-3-030-23483-6_14
Download citation
DOI: https://doi.org/10.1007/978-3-030-23483-6_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-23482-9
Online ISBN: 978-3-030-23483-6
eBook Packages: MedicineMedicine (R0)