Geriatric Psychiatry – What Are the Three Most Common Diagnosis in Geriatric Psychiatry?
There are three major Geriatric Psychiatry disorders among the older population. They are dementia, delirium, and generalized anxiety disorder. Each of these conditions is very serious, but they are all treatable and can lead to a better quality of life. These illnesses can range from mild to severe and can also be caused by several medical conditions.
Delirium, dementia, and depression
These three disorders have varying symptoms, but most are reversible with treatment. The symptoms of delirium are short and fluctuating, while those of dementia are more permanent. Treatment is focused on slowing the progression of the disease.
Symptoms of delirium can be mild or severe and can occur during the day or night. The best treatment is to treat the underlying causes, including addressing the patient’s basic needs. A reassuring approach with effective communication, reorientation and environmental interventions can help improve the patient’s quality of life.
Delirium and dementia are often co-occurring conditions. A common underlying medical problem can cause delirium, characterized by disorganized thinking and acute confusion. A variety of medications can contribute to this symptomatology in elderly patients. For example, benzodiazepines, anticholinergic drugs, and narcotic pain medications may lead to delusions or delirium.
A prospective cohort study of elderly patients in a Taiwanese tertiary medical center investigated the relationship between these three psychiatric disorders. It analyzed patients over the age of 65 who were admitted to a geriatric ward. Patients were assessed for depression and delirium using the Geriatric Depression Scale Short Form and the Mini-Mental State. The patient’s functional status was also evaluated on admission and at discharge using the Barthel Index.
Generalized anxiety disorder
Generalized anxiety disorder (GAD) is one of the most common mental health problems among the elderly. It can present in atypical ways and can occur in conjunction with other mental health problems, such as depression. These co-occurring conditions can make treatment more difficult. GAD treatment requires a step-by-step approach integrating non-pharmacological and pharmacological interventions. Treatment plans must also be customized to the patient’s age and health condition.
Although GAD can strike at any age, its onset is most common in later life. The prevalence of GAD in older adults varies from 1% to 7%. The disorder can affect older adults differently than younger people, and the symptoms may be easier to articulate than those of younger people. It can interfere with daily activities and reduce the overall sense of well-being.
People with GAD experience constant worry about a variety of things. This can range from financial concerns to family problems. It can also affect one’s ability to relax and sleep. It can also affect one’s ability to concentrate, resulting in chest pain, muscle tension, and difficulty swallowing.
Delirium
Delirium is a syndrome in which a patient has difficulty with cognition, memory, or orientation. It is caused by a number of factors, including acute deterioration of cognition, behavior, or function. Patients with delirium are often confused about their own time and place and may be unable to tell the difference between recent and past events.
The primary goal of treatment for delirium is to identify the underlying cause. Because so many factors can cause delirium, it is essential to find out what they are as early as possible. This includes a thorough medical history, with particular attention to the presence of any CNS-active substances. A physical examination is also necessary. In addition to somatic and neuropsychological assessment, lab values should include the following: blood glucose, electrolytes, liver and kidney function, thyroid hormones, and urinary status. A bone and joint examination are also necessary.
Treatment for delirium includes oxygenation, correction of fluid and electrolyte imbalances, discontinuation of unnecessary medications, and early removal of bladder catheters. Behavioral therapy is another treatment option. Patients suffering from delirium often need to be hospitalized for longer than usual because of underlying medical conditions.
Depression
While geriatric depression is common, it can be challenging to identify. Many factors may mask its symptoms, including co-existing medical conditions, a lack of family support, and low socioeconomic status. The stigma that is associated with mental illness may also hinder its accurate diagnosis. However, studies have shown that physicians who seek to recognize signs and symptoms of depression are more likely to make a diagnosis.
While there are no known cures for this mental disorder, treatment can significantly improve the quality of life for patients. Medications for depression may help relieve some symptoms, and therapy may prevent recurring episodes. Depending on the severity and duration of each episode, treatment may take weeks or months.
Depression is a severe mental disorder that can negatively impact the lives of older adults. While some feelings of sadness or “blue moods” are normal and expected during aging, prolonged, persistent depression is a severe medical problem. Studies have shown that moderate or higher depressive symptoms are associated with a greater risk of suicidal behavior.