Practical Management of Affective Disorders in Older People: A Multi-Professional Approach

287 Pages·2016·4.04 MB·English

by  Stephen Curran

Practical Management of Affective Disorders
in Older People

Practical Management of Affective
Disorders in Older People
A multi-professional approach
Edited by
Professor STEPHEN CURRAN
Consultant in Old Age Psychiatry
Fieldhead Hospital
Wakefi eld
and
Professor JOHN P WATTIS
Visiting Professor of Old Age Psychiatry
Centre for Health and Social Care Research
University of Huddersfi eld
Foreword by
Professor KEN WILSON
Professor of Old Age Psychiatry
University of Liverpool
Boca Raton London New York
CRC Press is an imprint of the
Taylor & Francis Group, an informa business
First published 2008 by Radcliffe Publishing
Published 2016 by CRC Press
Taylor & Francis Group
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Boca Raton, FL 33487-2742
© 2008 Stephen Curran and John P Wattis
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
ISBN-13: 978-1-84619-101-5(pbk)
Stephen Curran and John P Wattis have asserted their right under the Copyright, Designs and
Patents Act 1998 to be identifi ed as the authors of this work.
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is intended for use by medical, scientific or healthcare professionals and is provided strictly as a supplement to the
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is strongly urged to consult the relevant national drug formulary and the drug companies’ and device or material
manufacturers’ printed instructions, and their websites, before administering or utilizing any of the drugs, devices or
materials mentioned in this book. This book does not indicate whether a particular treatment is appropriate or
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Contents
Foreword vii
Preface ix
About the editors x
Contributors xi
1 Affective disorders in the new millennium 1
John P Wattis
2 Affective disorders in old age: detection and clinical
features 17
Cornelius Katona
3 Aetiology of late-life affective disorders 25
Adrian Lloyd
4 Pharmacological management of depression in older
people 54
Stephen Curran, Andrew Byrne and John P Wattis
5 Pharmacological treatment of bipolar affective disorder in
old age 80
Naila Jawaid and Robert Baldwin
6 Electricity, magnetism and mood 94
Susan Mary Benbow
7 Psychotherapy with older people 108
Ian Andrew James
8 Depression in physically ill older patients 126
Graham Mulley
9 Relationship between physical illness and affective
disorders 144
Richard Marriott
10 Depression in primary care 161
Stephen Iliffe
11 The role of the nurse in the assessment, diagnosis and
management of patients with affective disorders 173
Richard Clibbens and Paula Rylatt
12 Occupational therapy and affective disorders 194
Mary Duggan
13 Social services for older people with depression 205
Jill Manthorpe
14 Carer and service user perspectives of affective disorders
in older adults 217
Virginia Minogue
15 Cultural aspects of affective disorders in older people 230
Anilkumar Pillai
16 Religion/spirituality and depression in old age 242
Rachel Dew and Harold Koenig
17 An overview of human drug development 253
Chris Bushe
Index 265
Foreword
This book shines a light into the dark room of depression. The editors have built a
unique perspective through expert contributions from a wide range of specialists,
service providers, service users and researchers. The reader is taken on an exciting
and informative journey through current literature, contentious issues and the
diversity of affective disorders in older people.
The fi rst chapter gives an overview of depression and bipolar affective disorder
in both a historical and contemporaneous context. The progression of subsequent
chapters takes the reader deeper into diagnosis, aetiology and management.
Having been provided with a strong foundation, the reader moves on to those
areas that continually frustrate, puzzle and excite clinicians, researchers and
service providers. Despite the paucity of research, these areas provide some
of the most contentious and diffi cult challenges facing modern medicine. The
relationships between affective disorders and physical health, cognitive integrity,
psychosocial and spiritual aspects of the human condition are explored. These
issues are refl ected in the chapters devoted to intervention and management.
Within these chapters are updates on electro-convulsive treatments and, interest-
ingly, on the use of magnets in the treatment of depression. There is an easy-to-
read but well-informed chapter on psychotherapy with useful case illustrations.
The chapter relating to drug treatments is well founded in scientifi c evidence
and also draws attention to the developing public interest in herbal and other
remedies.
One of the main attractions of this book is the way in which the editors have
managed to cater for an eclectic readership. In other books, this approach can be
at the expense of focus and clarity. However, the complexity of affective disorders
in older people and the acknowledged practice of working in multi-professional
teams and crossing boundaries between secondary, primary and social care
demands such an approach. The informed and useful inclusion of service users’
perspectives and the innovative and interesting chapter on spirituality adds to the
adventure.
vii
viii FOREWORD
There is no doubt that this book is good, fun and interesting. The editorial style
makes it easy to read and the reader will come away with enthusiasm for working
in this fi eld, which is, after all, probably one of the most challenging and interesting
fi elds you can be involved in.
Professor Ken Wilson
Professor of Old Age Psychiatry
University of Liverpool
FFeebbrruuaarryy 22000088
Preface
This is the fourth in a group of books for professionals working with the elderly. The
parent book Practical Psychiatry of Old Age has proved popular and enduring and
is now in its fourth edition. This introductory book has now been supplemented
by multi-professional works which explore different areas of old age psychiatry
in greater detail and from a variety of perspectives. Practical Management of
Dementia: a multi-professional approach was the fi rst of these. This was followed
by Practical Old Age Psychopharmacology: a multi-professional approach and now
by this volume on affective disorders.
Our aim in editing these multi-author works is not only to go into more depth
than is possible in a general introductory text like Practical Psychiatry of Old Age
but also to develop an overview from a variety of perspectives. This view is intend-
ed to provide a balanced and inclusive view about the different contributions of
different disciplines, patients and carers into the practical management of the main
disorders of mental health in old age.
In this volume we have invited chapters from a variety of experts on areas
such as aetiology, diagnosis and psychological and pharmacological treatment.
In addition, we have included chapters that adopt a more contextual approach
to the management of affective disorders in areas like primary care and geriatric
medicine. Other chapters look at what specifi c disciplines such as nursing, social
work and occupational therapy have to offer. We have sought to include the
user and carer viewpoint and the important and often neglected spiritual aspects
of managing affective disorders. We trust, therefore, that this book will be a
useful resource for all members of the multi-professional team. It will help them
understand the contributions of other disciplines but most of all it will help them
adopt a balanced and practical approach to the management of a very important
group of disorders in old age.
Stephen Curran and John P Wattis
FFeebbrruuaarryy 22000088
ix