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Geriatric Psychiatry-Old age Psychiatry PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Geriatric psychiatry - Old age psychiatry" by Zoltán Hidasi MD. Know why Geriatric psychiatry and and its physical, mental and social aspects. Know about mental disorders in general.

Tags : Geriatric psychiatry, mental disorders

Published on : Mar 15, 2023 | Views : 1888 | Downloads : 2

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Slide 1-

Geriatric psychiatry“Old age” psychiatry Zoltán Hidasi MD
Slide 2-

Geriatric psychiatry What is „Geriatric”? Physical, mental and social aspects Mental disorders in general Different disorders in the elderly Psychiatric therapies in the elderly
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„Old age”?
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Gladys Burrill 92 y Honolulu Marathon 2010. Fauja Singh 100 y Toronto Marathon 2011 (Guinness record)
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Getting older v. living longer Physical changes – somatic diseases Musculosceletal Cardiovascular Metabolic Endocrin Gastrointestinal Sensory deficits Brain (vascular, degenerative, etc.)
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Getting older v. living longer Mental changes Personality amplification of character traits Cognition, memory mental slowing transformed memory structure summerised experiences Emotional changes Emotional maturity
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Getting older v. living longer Social changes Retirement (financial difficulties) Decrease in social status Facing somatic and mental disfunctioning Somatic diseases Grief (loss of spouse, brothers or sisters, friends) Social isolation Moving to nursing/residential home
Slide 8-

Mental disorders in elderly?Questions 65+ ?? Prevalence? 10-25% DSM? ICD? Child – adult –geriatric psychiatry? Geriatry – psychiatry –internal medicine? Organic – old age – neuro-psychiatry? GP?
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Mental disorders in general Biological, psychological, social factors (bio-psycho-social model) Internal medical, neurological, psychiatric aspects Multidimensonal approach Polimorbidity! Syndromatology (atypical) – etiology Cross-sectional –long term course
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Mental disorders in the elderly Dementia Other „organic mental disorders” Affective disorders (depression) Delirium Delusional disorders (psychosis) Anxiety disorders Substance abuse disorders Psychiatric patients getting old
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Dementia - Syndromatology Chronic course (10% above 65 y, 16-25% above 85 y) Multiple cognitive deficits incl. memory impairment (intelligence, learning, language, orientation, perception, attention, judgement, problem solving, social functioning) No impairment of consciousness Behavioural and psychological symptoms of dementia (BPSD) Progressive - static Reversible (15%) - irreversible
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Dementia - Classification Severity Mild cognitive impairment (MCI) Mild dementia Moderate dementia Severe dementia Localization Cortical Subcortical Etiology
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Dementia -Etiology Alzheimers disease (60-70%) Vascular dementia (10-20%) Neurodegenerative disorders (Pick, Lewy body dis, Parkinson, Huntington, etc.) Drugs and toxins Intracranial masses Anoxia Trauma Infections (JCD, HIV, etc) Nutrition Metabolic Pseudodementia
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Affective disorders (depression) Major depression prevalence: 10-16% (hospital, residential homes) Minor depression: 47-53 % Suicide in elderly 2-3 x average over 65 Major depression in 80%
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Suicidal attempts in 5 years age groups in Hungary, 2002 (Hungarostudy: Kopp et al) Suicidal attempts
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Depression in old age Dysthymic disorder, subthreshold depression Atypical syndromatology Cognitive symptoms (attention, concentration, memory problems) - pseudodementia Somatic complaints –somatoform symptoms (e.g. pain), hypochondriasis negativism, inactivity, loss of energy, fatigue, insomnia psychomotor agitation (or retardation), irritability, anxiety Psychotic symptoms, paranoid symptoms Comorbid somatic disorders Increased suicidal risk
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Delusional disorders (psychoses) Late onset schizophrenia (over 40 y) Very late onset schizophreniform disorder (over 60 y) Other delusional disorders Organic delusional disorder Delusional symptoms of dementia (BPSD) Multiple etiology, multiple syndromatology (schizophreniform, persecutory, hallucinosis, coenaesthesias, etc.)
Slide 18-

Psychosocial factors Personality „Endogenous” origin Organic (CNS) background Sensory impairment Other biological factors Delusional disorder in elderly
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Anxiety disorders High prevalence Atypical symptoms Somatoform/behavioural symptoms Psychosocial stressors Comorbidity somatic psychiatric
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Substance abuse Alcohol/medication abuse Common comorbidity somatic psychiatric (anxiety, depression, etc.)
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Psychiatric patients getting old Schizophrenia / bipolar disorder Personality disorder Neurotic disorders anxiety, somatoform, etc. Changes in clinical picture, therapeutical response, etc. Bio-psycho-social changes Multidimensional approach
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Psychiatric therapies in the elderly Pharamcotherapy Other biological therapies (ECT) Psychotherapies –social therapies Improving cognitive functioning Rehabilitation Treating primary or associated mood-anxiety disorder
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Pharmacotherapy Aspects of pharmacotherapy Mental status, neurological/somatic status Social status Etiology Special aspects Polimorbidity Pharmacokinetics (interactions) Dosage (low) Side effects (cognitive, other)
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