Skip to main content

Psychiatric Disorders Due to a General Medical Condition

  • Chapter
  • First Online:
Psychiatric Disorders Late in Life

Abstract

Older adults present with a complex array of medical disorders that present with or worsen comorbid psychiatric disorders. Additionally the treatment of these disorders can result in or worsen the comorbid psychiatric disorders. Poor clinical awareness, lack of assessment tools specifically designed for use among older adults, and the confusion in presentation of these medical disorders can result in under- or misdiagnosis of these conditions. Early diagnosis and prompt interventions can minimize the adverse outcomes from these medical disorders and improve the quality of life of older adults.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Centers ford Disease Control (CDC). The state of aging and health in America 2013. Atlanta, GA: US Department of Health and Human Services; 2013.

    Google Scholar 

  2. Centers ford Disease Control (CDC) & Directors NACD. The state of mental health and aging in America issue brief 1: what do the data tell us? Atlanta, GA: US Department of Health and Human Services; 2013.

    Google Scholar 

  3. Mangoni AA, Jackson SH. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol. 2004;57(1):6–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Abou-Saleh MT, Katona C, Kumar A. Principles and practice of geriatric psychiatry. 3rd ed. Chichester, West Sussex: John Wiley & Sons; 2011.

    Google Scholar 

  5. Klotz U. Pharmacokinetics and drug metabolism in the elderly. Drug Metab Rev. 2009;41(2):67–76. https://doi.org/10.1080/03602530902722679.

    Article  CAS  PubMed  Google Scholar 

  6. Mattson MP, Magnus T. Ageing and neuronal vulnerability. Nat Rev Neurosci. 2006;7(4):278–94. https://doi.org/10.1038/nrn1886.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Mattay VS, Fera F, Tessitore A, Hariri AR, Berman KF, Das S, et al. Neurophysiological correlates of age-related changes in working memory capacity. Neurosci Lett. 2006;392(1–2):32–7. https://doi.org/10.1016/j.neulet.2005.09.025.

    Article  CAS  PubMed  Google Scholar 

  8. Varma S, Sareen H, Trivedi JK. The geriatric population and psychiatric medication. Mens Sana Monogr. 2010;8(1):30–51. https://doi.org/10.4103/0973-1229.58818.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother. 2007;5(4):345–51. https://doi.org/10.1016/j.amjopharm.2007.12.002.

    Article  PubMed  Google Scholar 

  10. Sganga F, Landi F, Ruggiero C, Corsonello A, Vetrano DL, Lattanzio F, Cherubini A, Bernabei R, Onder G. Polypharmacy and health outcomes among older adults discharged from hospital: results from the CRIME study. Geriatr Gerontol Int. 2015;15(2):141–6. https://doi.org/10.1111/ggi.12241.

    Article  PubMed  Google Scholar 

  11. Dolder CR, Mckinsey J. Antipsychotic polypharmacy among patients admitted to a geriatric psychiatry unit. J Psychiatr Pract. 2011;17(5):368–74. https://doi.org/10.1097/01.pra.0000405368.20538.cd.

    Article  PubMed  Google Scholar 

  12. Casagrande Tango R. Psychiatric side effects of medications prescribed in internal medicine. Dialogues Clin Neurosci. 2003;5(2):155–65.

    PubMed  PubMed Central  Google Scholar 

  13. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113(12):941–8.

    Article  CAS  PubMed  Google Scholar 

  14. Schmader KE, Hanlon JT, Pieper CF, Sloane R, Ruby CM, Twersky J, et al. Effects of geriatric evaluation and management on adverse drug reactions and suboptimal prescribing in the frail elderly. Am J Med. 2004;116(6):394–401. https://doi.org/10.1016/j.amjmed.2003.10.031.

    Article  PubMed  Google Scholar 

  15. Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. N Engl J Med. 2015;373(10):929–38. https://doi.org/10.1056/NEJMoa1406761.

    Article  CAS  PubMed  Google Scholar 

  16. Bell SP, Orr NM, Dodson JA, Rich MW, Wenger NK, Blum K, et al. What to expect from the evolving field of geriatric cardiology. J Am Coll Cardiol. 2015;66(11):1286–99. https://doi.org/10.1016/j.jacc.2015.07.048.

    Article  PubMed  PubMed Central  Google Scholar 

  17. By the American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227–46. https://doi.org/10.1111/jgs.13702.

    Article  Google Scholar 

  18. Bergen G, Stevens MR, Burns ER. Falls and fall injuries among adults aged ≥65 years – United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(37):993–8. https://doi.org/10.15585/mmwr.mm6537a2.

    Article  PubMed  Google Scholar 

  19. Bower ES, Wetherell JL, Petkus AJ, Rawson KS, Lenze EJ. Fear of falling after hip fracture: prevalence, course, and relationship with one-year functional recovery. Am J Geriatr Psychiatry. 2016;24(12):1228–36. https://doi.org/10.1016/j.jagp.2016.08.006.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Brown PJ, Rutherford BR, Yaffe K, Tandler JM, Ray JL, Pott E, Chung S, Roose SP. The depressed frail phenotype: the clinical manifestation of increased biological aging. Am J Geriatr Psychiatry. 2016;24(11):1084–94. https://doi.org/10.1016/j.jagp.2016.06.005.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Scholz AF, Oldroyd C, McCarthy K, Quinn TJ, Hewitt J. Systematic review and meta-analysis of risk factors for postoperative delirium among older patients undergoing gastrointestinal surgery. Br J Surg. 2016;103(2):e21–8. https://doi.org/10.1002/bjs.10062.

    Article  CAS  PubMed  Google Scholar 

  22. American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Association; 2013.

    Book  Google Scholar 

  23. Sher Y, Miller Cramer AC, Ament A, Lolak S, Maldonado JR. Valproic acid for treatment of hyperactive or mixed delirium: rationale and literature review. Psychosomatics. 2015;56(6):615–25. https://doi.org/10.1016/j.psym.2015.09.008.

    Article  PubMed  Google Scholar 

  24. Odiari EA, Sekhon N, Han JY, David EH. Stabilizing and managing patients with altered mental status and delirium. Emerg Med Clin North Am. 2015;33(4):753–64. https://doi.org/10.1016/j.emc.2015.07.004.

    Article  PubMed  Google Scholar 

  25. Sikka V, Kalra S, Galwankar S, Sagar G. Psychiatric emergencies in the elderly. Emerg Med Clin North Am. 2015;33(4):825–39. https://doi.org/10.1016/j.emc.2015.07.009.

    Article  PubMed  Google Scholar 

  26. American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. Postoperative delirium in older adults: best practice statement from the American Geriatrics Society. J Am Coll Surg. 2015;220(2):136–148.e131. https://doi.org/10.1016/j.jamcollsurg.2014.10.019.

    Article  Google Scholar 

  27. Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER cluster randomized trial. JAMA Intern Med. 2014;174(6):890–8. https://doi.org/10.1001/jamainternmed.2014.949.

    Article  PubMed  Google Scholar 

  28. Garrido MM, Prigerson HG, Penrod JD, Jones SC, Boockvar KS. Benzodiazepine and sedative-hypnotic use among older seriously ill veterans: choosing wisely? Clin Ther. 2014;36(11):1547–54. https://doi.org/10.1016/j.clinthera.2014.10.007.

    Article  PubMed  Google Scholar 

  29. Reinhardt MM, Cohen CI. Late-life psychosis: diagnosis and treatment. Curr Psychiatry Rep. 2015;17(2):1. https://doi.org/10.1007/s11920-014-0542-0.

    Article  PubMed  Google Scholar 

  30. Darker CD, Sweeney BP, Barry JM, Farrell MF, Donnelly-Swift E. Psychosocial interventions for benzodiazepine harmful use, abuse or dependence. Cochrane Database Syst Rev. 2015;5:CD009652. https://doi.org/10.1002/14651858.CD009652.pub2.

    Google Scholar 

  31. Bodley-Tickell AT, Olowokure B, Bhaduri S, White DJ, Ward D, Ross JD, Smith G, Duggal HV, Goold P. Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system. Sex Transm Infect. 2008;84(4):312–7. https://doi.org/10.1136/sti.2007.027847.

    Article  CAS  PubMed  Google Scholar 

  32. Girard TD, Jackson JC, Pandharipande PP, Pun BT, Thompson JL, Shintani AK, et al. Delirium as a predictor of long-term cognitive impairment in survivors of critical illness. Crit Care Med. 2010;38(7):1513–20. https://doi.org/10.1097/CCM.0b013e3181e47be1.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Stern RA, Robinson B, Thorner AR, Arruda JE, Prohaska ML, Prange AJ. A survey study of neuropsychiatric complaints in patients with Graves’ disease. J Neuropsychiatry Clin Neurosci. 1996;8(2):181–5. https://doi.org/10.1176/jnp.8.2.181.

    Article  CAS  PubMed  Google Scholar 

  34. Trasciatti S, Prete C, Palummeri E, Foppiani L. Thyroid storm as precipitating factor in onset of coma in an elderly woman: case report and literature review. Aging Clin Exp Res. 2004;16(6):490–4.

    Article  PubMed  Google Scholar 

  35. Fukui T, Hasegawa Y, Takenaka H. Hyperthyroid dementia: clinicoradiological findings and response to treatment. J Neurol Sci. 2001;184(1):81–8.

    Article  CAS  PubMed  Google Scholar 

  36. Boelaert K, Torlinska B, Holder RL, Franklyn JA. Older subjects with hyperthyroidism present with a paucity of symptoms and signs: a large cross-sectional study. J Clin Endocrinol Metab. 2010;95(6):2715–26. https://doi.org/10.1210/jc.2009-2495.

    Article  CAS  PubMed  Google Scholar 

  37. Yamagishi A, Morita T, Miyashita M, Kimura F. Symptom prevalence and longitudinal follow-up in cancer outpatients receiving chemotherapy. J Pain Symptom Manag. 2009;37(5):823–30. https://doi.org/10.1016/j.jpainsymman.2008.04.015.

    Article  Google Scholar 

  38. Savard J, Ivers H, Savard MH, Morin CM. Cancer treatments and their side effects are associated with aggravation of insomnia: results of a longitudinal study. Cancer. 2015;121(10):1703–11. https://doi.org/10.1002/cncr.29244.

    Article  PubMed  Google Scholar 

  39. Celano CM, Freudenreich O, Fernandez-Robles C, Stern TA, Caro MA, Huffman JC. Depressogenic effects of medications: a review. Dialogues Clin Neurosci. 2011;13(1):109–25.

    PubMed  PubMed Central  Google Scholar 

  40. Bataille B, Delwail V, Menet E, Vandermarcq P, Ingrand P, Wager M, Guy G, Lapierre F. Primary intracerebral malignant lymphoma: report of 248 cases. J Neurosurg. 2000;92(2):261–6. https://doi.org/10.3171/jns.2000.92.2.0261.

    Article  CAS  PubMed  Google Scholar 

  41. Kesari S, Batchelor TT. Leptomeningeal metastases. Neurol Clin. 2003;21(1):25–66.

    Article  PubMed  Google Scholar 

  42. Scott JG, Bauchet L, Fraum TJ, Nayak L, Cooper AR, Chao ST, et al. Recursive partitioning analysis of prognostic factors for glioblastoma patients aged 70 years or older. Cancer. 2012;118(22):5595–600. https://doi.org/10.1002/cncr.27570.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Fuchs-Lacelle S, Hadjistavropoulos T. Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC). Pain Manag Nurs. 2004;5(1):37–49.

    Article  PubMed  Google Scholar 

  44. Herr K, Coyne PJ, Key T, Manworren R, McCaffery M, Merkel S, Pelosi-Kelly J, Wild L, American Society for Pain Management Nursing. Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Manag Nurs. 2006;7(2):44–52. https://doi.org/10.1016/j.pmn.2006.02.003.

    Article  PubMed  Google Scholar 

  45. Wilkinson F. Auras and other hallucinations: windows on the visual brain. Prog Brain Res. 2004;144:305–20. https://doi.org/10.1016/S0079-6123(03)14421-4.

    Article  PubMed  Google Scholar 

  46. Hikichi T, Yoshida A. Time course of development of posterior vitreous detachment in the fellow eye after development in the first eye. Ophthalmology. 2004;111(9):1705–7. https://doi.org/10.1016/j.ophtha.2004.02.015.

    Article  PubMed  Google Scholar 

  47. Menon GJ, Rahman I, Menon SJ, Dutton GN. Complex visual hallucinations in the visually impaired: the Charles bonnet syndrome. Surv Ophthalmol. 2003;48(1):58–72.

    Article  PubMed  Google Scholar 

  48. Bódizs R, Sverteczki M, Lázár AS, Halász P. Human parahippocampal activity: non-REM and REM elements in wake-sleep transition. Brain Res Bull. 2005;65(2):169–76. https://doi.org/10.1016/j.brainresbull.2005.01.002.

    Article  PubMed  Google Scholar 

  49. Freinhar JP. Delusions of parasitosis. Psychosomatics. 1984;25(1):47–49, 53. https://doi.org/10.1016/S0033-3182(84)73096-9.

    Article  CAS  PubMed  Google Scholar 

  50. Foster AA, Hylwa SA, Bury JE, Davis MD, Pittelkow MR, Bostwick JM. Delusional infestation: clinical presentation in 147 patients seen at Mayo Clinic. J Am Acad Dermatol. 2012;67(4):673.e1–673.e10. https://doi.org/10.1016/j.jaad.2011.12.012.

    Article  Google Scholar 

  51. Bhatia MS, Jagawat T, Choudhary S. Delusional parasitosis: a clinical profile. Int J Psychiatry Med. 2000;30(1):83–91. https://doi.org/10.2190/BBDT-CGB9-BB3L-8HM3.

    Article  CAS  PubMed  Google Scholar 

  52. Lyell A. The Michelson lecture. Delusions of parasitosis. Br J Dermatol. 1983;108(4):485–99.

    Article  CAS  PubMed  Google Scholar 

  53. Slaughter JR, Zanol K, Rezvani H, Flax J. Psychogenic parasitosis. A case series and literature review. Psychosomatics. 1998;39(6):491–500. https://doi.org/10.1016/S0033-3182(98)71281-2.

    Article  CAS  PubMed  Google Scholar 

  54. Ely EW, Stephens RK, Jackson JC, Thomason JW, Truman B, Gordon S, Dittus RS, Bernard GR. Current opinions regarding the importance, diagnosis, and management of delirium in the intensive care unit: a survey of 912 healthcare professionals. Crit Care Med. 2004;32(1):106–12. https://doi.org/10.1097/01.CCM.0000098033.94737.84.

    Article  PubMed  Google Scholar 

  55. Bolton C, Young G. Uremic encephalopathy. In: Neurological complications of renal disease. Stoneham: Buttersworth; 1990. p. 44.

    Google Scholar 

  56. Bommersbach TJ, Lapid MI, Rummans TA, Morse RM. Geriatric alcohol use disorder: a review for primary care physicians. Mayo Clin Proc. 2015;90(5):659–66. https://doi.org/10.1016/j.mayocp.2015.03.012.

    Article  PubMed  Google Scholar 

  57. Moroni M, Antinori S. HIV and direct damage of organs: disease spectrum before and during the highly active antiretroviral therapy era. AIDS. 2003;17(Suppl 1):S51–64.

    Article  PubMed  Google Scholar 

  58. Singer EJ, Thames AD. Neurobehavioral manifestations of human immunodeficiency Virus/AIDS: diagnosis and treatment. Neurol Clin. 2016;34(1):33–53. https://doi.org/10.1016/j.ncl.2015.08.003.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Meader N, Mitchell AJ, Chew-Graham C, Goldberg D, Rizzo M, Bird V, et al. Case identification of depression in patients with chronic physical health problems: a diagnostic accuracy meta-analysis of 113 studies. Br J Gen Pract. 2011;61(593):e808–20. https://doi.org/10.3399/bjgp11X613151.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Nakash O, Levav I, Aguilar-Gaxiola S, Alonso J, Andrade LH, Angermeyer MC, et al. Comorbidity of common mental disorders with cancer and their treatment gap: findings from the world mental health surveys. Psychooncology. 2014;23(1):40–51. https://doi.org/10.1002/pon.3372.

    Article  PubMed  Google Scholar 

  61. Cordova MJ, Andrykowski MA, Kenady DE, McGrath PC, Sloan DA, Redd WH. Frequency and correlates of posttraumatic-stress-disorder-like symptoms after treatment for breast cancer. J Consult Clin Psychol. 1995;63(6):981–6.

    Article  CAS  PubMed  Google Scholar 

  62. Unützer J, Katon W, Callahan CM, Williams JW, Hunkeler E, Harpole L, et al. Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA. 2002;288(22):2836–45.

    Article  PubMed  Google Scholar 

  63. Conde MV, Williams JW, Mulrow CD. Targeting depression interviewing: an exercise in diagnostic reasoning. J Gen Intern Med. 1998;13(4):262–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael C. Hann M.D., M.B.A., M.S. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hann, M.C., Meyer, A., Caporaso, E.N., Klotz, T.W. (2018). Psychiatric Disorders Due to a General Medical Condition. In: Tampi, R., Tampi, D., Boyle, L. (eds) Psychiatric Disorders Late in Life. Springer, Cham. https://doi.org/10.1007/978-3-319-73078-3_33

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-73078-3_33

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-73076-9

  • Online ISBN: 978-3-319-73078-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics