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5 - Management of late-life depression across primary and secondary care: case studies UK

Published online by Cambridge University Press:  18 December 2009

Carolyn A. Chew-Graham ,
Robert Baldwin  and
Alistair Burns
By
Helen Lester ,
Harry Allen ,
Simon Cocksedge ,
Joy Ratcliffe ,
Steve Iliffe ,
Cornelius Katona Dean  and
Dr Chris Fox
Carolyn A. Chew-Graham
Affiliation:
University of Manchester
Robert Baldwin
Affiliation:
Manchester Mental Health and Social Care NHS Trust
Alistair Burns
Affiliation:
University of Manchester
Helen Lester
Affiliation:
General Practitioner and Professor of Primary Care, School of Community Based Medicine University of Manchester
Harry Allen
Affiliation:
Consultant in Old-Age Psychiatry, Manchester Mental Health and Social Care Trust
Simon Cocksedge
Affiliation:
General Practitioner and Lecturer in General Practice, University of Manchester
Joy Ratcliffe
Affiliation:
Consultant in Old-Age Psychiatry, Manchester Mental Health and Social Care Trust
Steve Iliffe
Affiliation:
General Practitioner and Professor of Primary Care, Royal Free and University College, Medical School, London
Cornelius Katona Dean
Affiliation:
Consultant and Senior Lecturer in Psychiatry, Kent Institute of Medicine and Health Sciences, University of Kent
Dr Chris Fox
Affiliation:
Consultant and Senior Lecturer in Psychiatry Kent, Institute of Medicine and Health Sciences, University of Kent
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Summary

In the next three case commentaries we asked our contributors to comment on more complicated cases where input from both primary and secondary health care and social care would be necessary.

Depression with psychotic features

Mrs Paulette B is an African-Caribbean lady who came over to the UK 50 years ago with her husband. She raised six children who have all done very well and all except one live in different parts of the UK. When her husband died, Mrs PB threw herself into her work with the local church, helping run a group for young women and teaching in the Sunday School. For the last three months she has been off her food, unable to concentrate, less interested in things and reluctant to go to church, fearing that she will bring some calamity onto the congregation.

In the last two weeks, she has been aware of a man's voice warning her to stay at home and to avoid answering the telephone as her thoughts will be recorded. Initially she thought this might be her husband's voice but has now become convinced that it is the voice of the vicar and so when he called on her last week, she spoke to him through the door. She told him she knew that she had committed ‘the unforgivable sin’.

Type
Chapter
Information
Integrated Management of Depression in the Elderly , pp. 83 - 101
Publisher: Cambridge University Press
Print publication year: 2008

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References

Baldwin, R., Anderson, D., Block, S., et al. (2003) Guidelines for the management of late-life depression in primary care. Int. J. Geriatr. Psychiatry 18, 829–38.Google Scholar
Chantal, S., Everitt, H., Kendrick, T. (2005) Oxford Handbook of General Practice. Oxford, UK: Oxford University Press.
Dennis, M., Wakefield, P., Molloy, C., Andrews, H., Friedman, T. (2005) Self-harm in older people with depression: comparison of social factors, life events and symptoms. Br. J. Psychiatry 186, 538–9.Google Scholar
Department of Health (2001) National Service Framework for Older People. London: HMSO.
Department of Health (2002) Guidance on the Single Assessment Process for Older People, HSC2002/001: LAC (2002)1. London: HMSO.
Iliffe, S., Lenihan, P., Orrell, M., et al. and the SPICE Research Team (2004) Involving the public in changing clinical practice: the development of a short instrument to identify common unmet needs in older people in general practice. Br. J. Gen. Practice 54, 914–18.Google Scholar
Kewley, T., Bolton, J. (2006) A survey of liaison psychiatry services in general hospitals and accident and emergency departments: do we have the balance right?Psychiatr. Bull., 30, 260–3.Google Scholar
MHRA (2005) Committee on Safety of Medicines Advice on Atypical Antipsychotics and Stroke. London: Medicines and Healthcare Products Regulatory Agency. Available online at www.mhra.gov.uk/home/
NICE (2004a) Depression: Management of Depression in Primary and Secondary Care, Clinical Guideline No. 23. London: National Institute for Health and Clinical Excellence. Available online at www.nice.org.uk.
NICE (2004b) Self-Harm: The Short-Term Physical and Psychological Management and Secondary Prevention of Self-Harm in Primary and Secondary Care, Clinical Guideline No.16. London: National Institute for Health and Clinical Excellence. Available online at www.nice.org.uk.
NICE (2006) Parkinson's Disease: Diagnosis and Management in Primary and Secondary Care, Clinical Guideline No.35. London: National Institute for Health and Clinical Excellence. Available online at www.nice.org.uk.
NICE/SCIE (2006) Dementia: The Treatment and Care of People with Dementia in Health and Social Care, Clinical Guideline No. 42. London: National Institute for Health and Clinical Excellence/Social Care Institute for Excellence. Available online at www.nice.org.uk.
Paton, C., Ferrier, I. (2005) SSRIs and gastrointestinal bleeding. Br. Med. J., 331, 529–30.Google Scholar
Waern, M., Beskow, J., Runeson, B., Skoog, I. (1999) Suicidal feelings in the last year of life in elderly people who commit suicide. Lancet, 354, 917–18.Google Scholar
Waern, M., Rubenowitz, E., Runeson, B., et al. (2002) Burden of illness and suicide in elderly people: case-control study. Br. Med. J., 324, 1355–7.Google Scholar
World Health Organization (2002) Suicide Prevention. Available online at www.who.int/mental_health/prevention/suicide.

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