To describe the prevalence of drinking and smoking habits in an Italian population aged 75+.

A research by “Istituto Superiore della Sanità” found that drinking alcohol involves one-third of elderly over 65 years. In Italy, smoking habit in population over 65 involves 23% of men and 11% of women.

Cross-sectional study on a population of 462 subjects from the cohort of “The Faenza Community Aging Study” (De ronchi, 2005). All participants were interviewed with CAMDEX-R (Cambridge Examination for Mental Disorders of the Elderly - revised).

56,7% of interviewed subjects drank alcohol (men 74.8%, women 40.8%; p< 0,005).

Hundred and twentynine subjects (28,7%) were moderate drinkers (≥2 A.U./day).

The 20% of the drinkers (6,2% of the total population) consumed ≥ 3 alcohol units per day. When we asked them if they consider themselves like heavy drinker, only 3,9%, (80% men) answer “yes”.

The 56,9% (50,4% of the total and 58,3% women) of drinkers had symptoms of anxiety and 44,1% were affected by depression. Furthermore, among smokers the 51,1% had symptoms of anxiety and the 38% of depression.

Drinking and smoking habits are an increasing attitude in elderly. These un-healthy habits might have severe implications and aggravate the clinical conditions in otherwise frail persons. Our data suggest to general practitioners and policy makers to be aware of this problem to actively investigate drinking and smoking habits in the general population, to launch preventive campaigns and to study aversion therapy.

The National Institute for Clinical Excellence (NICE) has laid down certain guidelines for prescribing Anti-cholinesterases in patients with dementia. Keeping in mind the NICE guidance, an audit was conducted to see whether these were followed.

To ascertain the level of compliance to the NICE guidance and ensure they are adhered to.

The data was collected from patients attending the memory clinic at Park Royal Centre for Mental Health in Central London over a six month period. Sixteen patients were randomly selected for this audit. The baseline MMSE score was recorded and also the medication prescribed.

The baseline MMSE score in all the 16 (100%) patients was above the recommended score of 12.

The MMSE score was done in 12(75%) patients during follow up at 4–6 months.

Of the 12 available MMSE scores at follow up, none were below 12 and hence continued treatment.

In 2 (12.5%) patients there was an improvement, in 6 (37.5%) patients there was a fall and in 4 (25%) patients there was no change in the MMSE score at follow up.

It was found that the NICE guidance was followed in most (75%) patients.

The increase of elderly schizophrenia patients during the last few decades is a major health issue. Although life expectancy increased for patients with schizophrenia, there is a greater rate of the occurrence of somatic illnesses, and premature mortality remains 2 to 3 times higher in these patients than in general population.

To prospectively assess health care access, quality of life, functional status, and rates and causes of death in a cohort of elderly schizophrenia patients.

We initiated a national epidemiologic 5-year cohort study including a large sample of schizophrenic patients aged 60 or more. The first aim was to assess the geriatric psychiatric services provided by a large sample (n = 108) of departments of psychiatry in France (n = 829). The second aim was to assess the number of elderly schizophrenia patients followed by each participating centre. Finally, we prospectively assess some demographic, clinical and biological variables, as well as quality of life indexes.

The geriatric psychiatric services are heterogeneously spread in French territory. Schizophrenic patients aged 60 and more represent 15% of French public psychiatric department activity. The cohort is actually in course of constitution.

Our data may help to identify factors associated with increased morbidity and mortality in elderly schizophrenia.

Quetiapin is the only antipsychotic approved in the USA as a monotherapy for the treatment of both acute mania and depression associated with bipolar disorder.

The paper's objective was to research the capabilities of quetiapin in the treatment of a patient with treatment-resistant organic affective disorder.

Considering the existence of recommendations for introducing an atypical antipsychotic as a therapy in the treatment of unipolar depression, we will demonstrate our experience in that indication.

The subject is a 69 year old patient whose mental disorders appeared for the first time two years ago. The current hospitalization occurred due to depressive and psychotic symptoms and suicidal tendencies. Since the patient had psychomotor inhibition to the point of stupor, and in order to obtain anamnestic data on cognitive disturbances, due to a diagnostic dilemma (dementia or pseudodementia within the affective disorder) the relevant diagnostics were completed: structured psychiatric interview, laboratory tests, internist examination, a brain scan, MMS test, HAM/D17, and CGI/S. Due to a poor response to the therapy and unwanted side effects of the applied drugs, the therapy was modified several times.

Quetiapin was introduced to the therapy up to a dose of 400 mg/d. With the introduction of quetiapin there was a reduction in the psychopathology. Improvement was noted in cognitive and work and social functioning.

The introduction of quetiapin as a monotherapy turned out to be effective in the treatment of therapy-resistant organic affective disorder, with good tolerability and no side effects.

To detect phenomenological gender differences in elderly patients with depression for better understanding. In addition to illustrate neuro- psychological gender differences in elderly patients with depression for better management.

A case/control, comparative study with consecutive sample. 80 elderly Egyptian subjects of both sexes aged 60 years or above recruited from psychiatry outpatient clinic in Kasr Al Aini and Beni Suef hospitals with no obvious cognitive impairment or substance related psychiatric disorders. The subjects were classified into 2 groups (depressed patients and control groups) 40 subjects each.

Diagnostic criteria of the DSM-IV TR, Symptom checklist, MMSE, GDS,WAIS and STAI were used.

Comparison between the depressed patients and the control group revealed that the depressed group has affected cognitively than the control group as assessed by MMSE and also showed deterioration of intellectual abilities (deterioration index). Comparison between the depressed males and females subgroups revealed that the characteristics of the patients and correlates of depression are similar in both sexes except for some significant findings e.g, depression in elderly women is more associated with widowhood, more suffering of sense of worthlessness, more affection of attention and more disturbance in reasoning and costructional abilities.

Depression in older patients is related to widowhood, presence of family conflicts an positive past history of depression. There were no gender differences in elderly depressed patients except for that depression in elderly women is more associated with widowhood, sense of worthlessness, more affection of attention and more disturbance in reasoning.

Alzheimer's disease (AD) is often accompanied and worsened by malnutrition.

The aim of this study is to investigate the relationship between weight loss and behavioral symptoms in institutionalized severe AD patients.

All subjects were recruited from Asahi Hospital, a long-term care facility.

The diagnosis of AD was made in accordance with the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria. The inclusion criteria were (1) an MMSE score of 12 or less, (2) stable physical condition for at least three months. Exclusion criteria were (1) presence of acute disorders such as infection, heart failure, or requiring special treatment and intensive care. Weight was measured monthly. At baseline, 12 weeks, and 24 weeks, each patient received the Mini-Mental State Examination (MMSE), the Barthel Index, and Neuropsychiatric Inventory (NPI).

We included 48 patients who were judged appropriate for the study. At baseline, the mean age was 83.3 ± 6.2, the mean weight was 41.8 ± 7.9, the mean body mass index (BMI) was 18.7 ± 3.5. During the 24 weeks of follow-up, 16 patients lost at least 3 kg of body weight, 20 patients remained stable, and 12 patients gained at least 3 kg of body weight. The mean NPI scores was significantly higher in the weight-loss group than in the weight-gain and weight-stable groups.

These preliminary results suggest that behavioral disturbances play a role in low body weight and weight loss in AD patients.

There is no general agreement on the prevalence of mental disorders in the elderly, although it is estimated that 25%. of them present psychiatric symptoms. Geriatric psychiatry is one of the most rapidly advancing fields and requires a comprehensive approach.

To analyse the characteristics of patients older than 65 who are attended at the psychiatry emergency room.

A descriptive study was conducted among all elderly pacients seen during May 2010 at the psychiatry emergency room at Vall d’Hebron University Hospital. Clinical variables (functional status, reason to show up, medical history, diagnosis), treatment and referral at discharge were analysed.

36 patients (44.4% men, mean age 75.3 years) were identified. Charlson comorbidity index was 2.08. Suicide attempts were the most frequent reason for admission (27.8%), followed by psychomotor agitation (16.7%), anxiety disorders (13.9%), delirium (13.9%), depression (11.1%), and behaviour disorders (8.3%). Concerning psychiatric antecedents 58.3% had depressive disorder and 40% reported somatic symptoms during the month prior to their consultation.

The most common diagnosis at discharge were anxiety-depressive disorders (52.7%) and delirium (16.7%). The most widely prescribed psychotropics were antipsychotics (19.4% haloperidol, 13.9% quetiapine) followed by benzodiazepines (13.9%). Referral at discharge was: 41.7% home, 13.9% midterm psychiatric units, 27.8% acute psychiatric inpatient unit and 16.7% Internal Medicine.

Typically, elderly patients attended at the psychiatric emergency room are diagnosed of an anxiety-depressive disorder and often present with a suicidal attempt, but only 41.7% are admitted as psychiatric inpatients.

Depression is often occurred after surgical interventions and may have serious consequences on postoperative recovery. The treatment of early discovered depressive symptoms may have strong influence on the recovery of operated orthopedic patients.

Simple and quick instrument for detection and evaluation of depressive symptoms could be of great use to doctors.

Work objectives are

1) determine the prevalence of depressiveness in preoperative period in patients with scheduled surgical interventions, and

2) validation of Geriatric Depression Scale - short form (GDS-SF) in detection of depressiveness.

A sample of 120 orthopedic patients is the part of larger sample in prospective research of depressiveness in patients in preoperative period with scheduled surgical interventions (except cardio-surgical). For estimation of depressiveness we used battery of tests (GDS-SF, BDI - Beck's depression scale, MDI - major depressive disorder questionnaire), and patients were tested 3 times: to 14 days prior the surgery, 7 and 90 days after the surgery. Validation of GDS-SF was examined compared to BDI according to age and gender of examinees.

In preliminary sample of 120 orthopedic patients with scheduled orthopedic interventions, prevalence of depressiveness is greater than prevalence of depressiveness in general population (p < 0.001). Depressiveness is much more present in women than in men (p < 0.001). Correlation of depressive scores in BDI and in GDS-SF is satisfactory for all age groups.

Preliminary results indicate on further research of depressiveness in preoperative period in order to confirm validation of GDS-SF as simpler alternative for early detection of depressiveness.

The purpose of this study was to assess Korean elderly people's residential condition with or without cohabitants, spouse and children, and to analyze their depression, spirituality and life satisfaction depending on residential condition.

160 subjects were randomly selected from one of religious organizations, Suwon City, Kyounggi Do, South Korea. The participants were divided into Group 1 (the elderly living alone: n = 74, Mean Age = 72.45, SD = 6.78) and Group 2 (the elderly living with spouse and/or children: n = 86, Mean Age = 72.12, SD = 6.82). The subjects participated in the survey forms of spiritual well-being, life satisfaction, and depression. It was hypothesized that the elderly living alone (Group 1) had lower scale in the areas of spiritual well-being, life satisfaction and higher scale in depression.

The t-test on the mean of each scale for the Group 1 and Group 2 was significant: Korean elderly people, who were living alone without family support, were less satisfied (p < .001), more depressed (p < .0001) and their spiritual well-being scale was lower (p < .001). For the total participants (n = 160). there was a positive correlation between spiritual well-being and life satisfaction (rho = .56, p < .001). There was negative correlation between depression and spiritual wellbeing (rho = −.67, p < .0001); depression and life satisfaction (rho = −.78, p < .0001).

For the mental health professionals, including psychiatrists and gerontologists, it is important to understand the elderly people's residential situation, emotional support as well as to assess their life satisfaction and spiritual well-being in terms of quality of life measurement.

Late-onset psychoses are a heterogeneous group of disorders whose nosology has been controversial throughout history. Several methodological limitations have made difficult the comparison among studies and, as a consequence, the research interest has been little, leading to the absence of late-onset schizophrenia and paraphrenia in current official classifications.

To highlight the specific symptoms of late-onset schizophrenia as well as its differences with other psychoses though the study of a case report.

A 70-year-old woman developed psychotic symptoms during the last seven years, consisting of auditory and olfactory hallucinations, telepathic phenomena and injury delusions, erotomania and thought control, with a high level of systematization and fantasy. She was admitted in an inpatient unit. She was treated with risperidone and the psychotic symptoms got better. At the time of hospital discharge, hallucinations and delusional thoughts had disappeared and no behavioral or emotional disorder was observed. Some weeks later, risperidone had to be substituted by paliperidone due to side effects, such as tremor, sialorrhea and parkinsonism.

Late-onset schizophrenic psychosis is not as exceptional as it has been traditionally considered. One of the main problems is that current classifications do not include specific diagnostic categories for cases of late or very-late-onset psychoses. It would be necessary that future ICD-11 and DSM-V classifications will include different-age criteria when diagnosing mental disorders.

Depression in later life is a major public heath issue. Few studies to date examined the psychiatric correlates of depression in elderly surveys in the general population.

To provide nationally representative data on the prevalence, sociodemographic correlates and comorbidity of current major depressive disorder in late life.

This study is based on a nationally representative survey, the National Epidemiologic Survey on Alcohol and Related Conditions, of the noninstitutionalized household population (8,205 respondents aged 65 and above). The past 12-months prevalence of major depressive disorder was estimated, and logistic regression analyses were used to examine the relationship between 12-months major depressive disorder and sociodemographic characteristics, general medical condition and psychiatric disorder. Diagnoses were made according to the of DSM-IV criteria.

Among the respondents, 3.2% individuals with a past 12-months diagnosis of major depressive disorder were identified. Women and individuals living in urban areas were more likely to be diagnosed with a major depressive disorder. Significant associations between major depressive disorder and cardiovascular, gastrointestinal diseases, arthritis were found. Several psychiatric disorder were associated with past 12-months major depressive disorder, including dysthymia, bipolar disorder, panic disorder, specific phobia, generalized anxiety disorder, nicotine and alcohol dependence, and histrionic personality disorder.

Recent Major depressive disorder in the elderly was associated with a large number of psychiatric disorders. This study highlights the need to develop effective and targeted intervention initiatives to detect major depressive disorder in elderly.

The prevalence of depression among older people receiving care is high, yet the rate of treatment of this disorder is low. One way to improve the pathway to care is to train care staff to recognise the symptoms of depression and raise their confidence in responding to them.

To evaluate the efficacy of the beyondblue Depression Training Program.

Staff (N = 148) from low level care facilities and community care facilities in metropolitan Melbourne completed the beyondblue Depression Training Program, while staff in other facilities (N = 96) acted as controls. Pre-, post- and follow-up questionnaire data were collected and referrals for depression by staff were recorded.

Training improved carers’ knowledge about depression, their self-efficacy in responding to signs of depression and their attitudes towards working with depressed aged care recipients. In addition, training increased the number of referrals for depression made by carers.

Training aged care staff in depression can improve the pathways to care for depressed care recipients, and has the potential to improve the quality of life of older people.

To determine the discharge destination of patients admitted to a psychogeriatric unit.

Records of all patients discharged from an in-patient psychogeriatric unit between 1st July 2009 and 30th June 2010 were examined. The diagnosis, residence at admission, length of stay and discharge destination were recorded.

There were ninety-four discharges over the study period. Four of the patients were admitted and discharged twice. The mean age was 76.7 years (range 65–95 years). 52.1% (n = 49) were diagnosed with dementia and 47.9% (n = 45) with functional mental illness. The average length of stay was 67.4 days for dementia compare to 74.2 days for functional mental illness. 17.1% (n = 6/32) of patients with dementia and 84.2% (n = 32/38) of patients with functional mental illness resident at home at the time of admission were discharged home.

This finding suggests that patients with functional mental illness are more likely to be discharge back to their homes compared with patients with dementia.

Parkinson's disease (PD) dementia is a rapidly growing global health problem. Dementia in PD is often accompanied with neuropsychiatric manifestations, such as depression, insomnia, visual hallucinations and psychomotor agitation, which need psychiatric attention.

The authors’ aim is to report a case of a 76-year-old female suffering from PD who was admitted to the psychiatric yard exhibiting neuropsychiatric symptoms. A literature's review about PD dementia was also made.

Patient had one psychiatric hospitalization at age 41, due to depressive symptoms. PD diagnose was made at age 65 and initially responded well to levodopa. Over the subsequent years, motor fluctuations and dyskinesias as well as autonomic, cognitive and psychological symptoms gradually developed. At 75 years, patient's family stated that she had been more forgetful, impulsive, showing signs of anxiety and dysphoria. She was hospitalized exhibiting psychomotor agitation, disorientation, insomnia and mainly nocturnal visual hallucinations with persons. Diagnostic testing included: cranial tomography which showed mild generalized atrophy but no other structural cause of her symptoms; laboratory tests with B12, folic acid, thyroid function; syphilis detection test and examinations of serum and urine were normal. The MMSE scored 19. Attention deficits and constructional apraxia were present in clock drawing test. Treatment was initiated with memantine and a low dose of quetiapine. She was discharged after 20 days with improvement of neuropsychiatric symptoms.

Early diagnosis and treatment of dementia in PD may prevent psychiatric hospitalization and avoid patient's and family's distress.