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Psychogeriatry: DR - Deddy Soestiantoro SPKJ Mkes
Psychogeriatry: DR - Deddy Soestiantoro SPKJ Mkes
NEUROPSYCHOLOGICAL EVALUATION
MEDICAL HYSTORY
MENTAL DISORDERS OF OLD AGE
-vertigo
-syncope
-hearing loss
PSYCHOPHARMACOLOGICAL TREATMENT OF
GERIATRIC DISORDERS
-especially usefull to bring in all medications used
-divided doses for psychotropic drugs
-liquid preparations sometimes better
-avoid polypharmacy and use monotherapy
-be carefull with AD reactions
-the most common : psychotropic drugs,CV and diuretics
OTC medications
PRINCIPLES
-the major goals: to improve the quality of life, maintain in the
community, avoid/delay in nursing homes placement
-basic tenet: individualization of dosage
-alteration dosages required because of the physiological
changes (renal,liver,CV,GI)
-increased risk of orthostatic hypotension from psycho-
tropic drugs is related to reduced functioning of of blood
pressure-regulating mechanisms
-conclusion- don’t forget to remember always:
START LOW - GO SLOW and MONITORING FREQUENTLY
ELECTROCOVULSIVE THERAPY
-it can be the most effective treatment option
-lowest risk of complications for older individuals with
comorbid medical conditions likely to produce drug-
disease and drug-drug interactions
-ECT can provide a rapid response, which is vitally
important in serious ill patients, those at risk due to
malnutrition or agitation related to psychiatric ilness,
and those at high risk for suicide
-ECT modification to prevent musculoskeletal seizures
is now considered as safe as, if not safer than,
medication for use in frail elderly patients
PSYCHOTHERAPY FOR GERIATRIC PATIENT
-Supportive Psychotherapy
-Life Review or Reminiscence Therapy
-Cognitive Behavior Therapy
-Brief ( Time-Limited ) Psychodynamic Psychotherapy
-Insight-Oriented Psychotherapy
-Integrated Therapy: integration of psychotherapies
often is the most effectve way to proceed.
PSYCHIATRIC SYMPTOMS ASSOCIATED WITH
SPECIFIC MEDICAL DISORDERS
-Cerebrovascular disease
-Cardiovascular disease
-Chronic diseases of the lung, kidneys and liver
-Arthritis
-Thyroid disease, malnutrition, and anemia
INSTRUMEN PENGUKURAN
DEPRESI