Clinical trials in late-life mood disorders

2016 ◽  
pp. 173-196
Author(s):  
Lucio Ghio ◽  
Werner Natta ◽  
Marco Vaggi ◽  
Luigi Ferrannini
Keyword(s):  
Clinical Trials ◽  
Mood Disorders ◽  
Late Life

Maintenance Interpersonal Psychotherapy (IPT-M)

2012 ◽  
pp. 341-364
Author(s):  
Mark D Miller ◽  
Ellen Frank ◽  
Jessica C Levenson
Keyword(s):  
Mood Disorders ◽  
Late Life ◽  
Interpersonal Psychotherapy ◽  
Personality Pathology ◽  
Protective Effects ◽  
Optimal Frequency ◽  
Term Efficacy ◽  
Psychotherapeutic Interventions ◽  
Over Time

Chapter 19 covers maintenance interpersonal psychotherapy (IPT-M), and that while effective psychotherapeutic and pharmacotherapeutic acute treatments for depression are well known, the problem of how to prevent relapse and recurrence has been a vexing one. It describes some of the studies designed to test the protective effects of maintenance pharmacotherapy and psychotherapy against relapse and recurrence, how with pharmacotherapy, judging long-term efficacy simply requires monitoring patients on a given dose of medication over time, but how psychotherapeutic interventions raise other issues. It covers IPT-M for late-life mood disorders, personality pathology, optimal frequency of IPT-M, research in this area, and a case example.

scholarly journals Mood Disorders in Late Life: A Population-based Analysis of Prevalence, Risk Factors, and Consequences in Community-dwelling Older Adults in Ontario: Troubles de l’humeur en âge avancé : Une analyse dans la population de la prévalence, des facteurs de risque et des conséquences chez des adultes âgés vivant en milieu communautaire en Ontario

2020 ◽  
Vol 65 (9) ◽  
pp. 630-640
Author(s):  
Rachel Strauss ◽  
Paul Kurdyak ◽  
Richard H. Glazier
Keyword(s):  
Risk Factors ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Potential Risk ◽  
Late Life ◽  
Population Based ◽  
Community Dwelling ◽  
Self Report ◽  
Term Care ◽  
Potential Risk Factors

Objective: Mental health issues in late life are a growing public health challenge as the population aged 65 and older rapidly increases worldwide. An updated understanding of the causes of mood disorders and their consequences in late life could guide interventions for this underrecognized and undertreated problem. We undertook a population-based analysis to quantify the prevalence of mood disorders in late life in Ontario, Canada, and to identify potential risk factors and consequences. Method: Individuals aged 65 or older participating in 4 cycles of a nationally representative survey were included. Self-report of a diagnosed mood disorder was used as the outcome measure. Using linked administrative data, we quantified associations between mood disorder and potential risk factors such as demographic/socioeconomic factors, substance use, and comorbidity. We also determined associations between mood disorders and 5-year outcomes including health service utilization and mortality. Results: The prevalence of mood disorders was 6.1% (4.9% among males, 7.1% among females). Statistically significant associations with mood disorders included younger age, female sex, food insecurity, chronic opioid use, smoking, and morbidity. Individuals with mood disorders had increased odds of all consequences examined, including placement in long-term care (adjusted odds ratio [OR] =2.28; 95% confidence interval [CI], 1.71 to 3.02) and death (adjusted OR = 1.35; 95% CI, 1.13 to 1.63). Conclusions: Mood disorders in late life were strongly correlated with demographic and social/behavioral factors, health care use, institutionalization, and mortality. Understanding these relationships provides a basis for potential interventions to reduce the occurrence of mood disorders in late life and their consequences.

scholarly journals Cannabidiol as a Treatment for Mood Disorders: A Systematic Review

2019 ◽  
Vol 65 (4) ◽  
pp. 213-227 ◽  
Author(s):  
Jairo Vinícius Pinto ◽  
Gayatri Saraf ◽  
Christian Frysch ◽  
Daniel Vigo ◽  
Kamyar Keramatian ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Mood Disorders ◽  
Observational Studies ◽  
Case Reports ◽  
Health Conditions ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Level Of Evidence ◽  
Mood Symptoms ◽  
Affective Symptoms

Objective: To review the current evidence for efficacy of cannabidiol in the treatment of mood disorders. Methods: We systematically searched PubMed, Embase, Web of Science, PsychInfo, Scielo, ClinicalTrials.gov , and The Cochrane Central Register of Controlled Trials for studies published up to July 31, 2019. The inclusion criteria were clinical trials, observational studies, or case reports evaluating the effect of pure cannabidiol or cannabidiol mixed with other cannabinoids on mood symptoms related to either mood disorders or other health conditions. The review was reported in accordance with guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Results: Of the 924 records initially yielded by the search, 16 were included in the final sample. Among them, six were clinical studies that used cannabidiol to treat other health conditions but assessed mood symptoms as an additional outcome. Similarly, four tested cannabidiol blended with Δ-9-tetrahydrocannabinol in the treatment of general health conditions and assessed affective symptoms as secondary outcomes. Two were case reports testing cannabidiol. Four studies were observational studies that evaluated the cannabidiol use and its clinical correlates. However, there were no clinical trials investigating the efficacy of cannabidiol, specifically in mood disorders or assessing affective symptoms as the primary outcome. Although some articles point in the direction of benefits of cannabidiol to treat depressive symptoms, the methodology varied in several aspects and the level of evidence is not enough to support its indication as a treatment for mood disorders. Conclusions: There is a lack of evidence to recommend cannabidiol as a treatment for mood disorders. However, considering the preclinical and clinical evidence related to other diseases, cannabidiol might have a role as a treatment for mood disorders. Therefore, there is an urgent need for well-designed clinical trials investigating the efficacy of cannabidiol in mood disorders.

Mood Disorders in Late Life

2016 ◽  
pp. 298-310
Author(s):  
Pat Arean ◽  
Eric Lenze ◽  
Joaquin A. Anguera
Keyword(s):  
Major Depression ◽  
Access To Care ◽  
Mood Disorders ◽  
Late Life ◽  
Later Life ◽  
Standardized Assessment ◽  
Younger Adults ◽  
Assessment Scores ◽  
Assessment And Treatment

This chapter discusses how clinicians will need to prepare for a worldwide exponentially growing aging community by describing the current scope of practices with respect to the assessment and treatment mood disorders, including minor and major depression. Particularly for those in later life, the meaningful interpretation of standardized assessment scores requires consideration of medical and neurological complexities. Clinicians must be flexible not only with respect to characterization, but especially with respect to treatment, given the inherent challenges associated with access to care and the range of disability amongst these individuals. Indeed, these late-life individuals are typically assessed in a similar fashion to younger adults (which may obscure meaningful interpretations), making understanding the nuances underlying existing behavioral and pharmaceutical approaches an essential endeavor.

Recent Advances in Late-Life Mood Disorders

2014 ◽  
Vol 3 (4) ◽  
pp. 245-252
Author(s):  
David A. Beck ◽  
Jacob A. Beck ◽  
Garrett Lambert
Keyword(s):  
Mood Disorders ◽  
Late Life ◽  
Recent Advances

scholarly journals Body Clock: Matching Personalized Multimorbidity and Fast Aging Using Information Entropy

2021 ◽  
Author(s):  
Shabnam Salimi ◽  
Ali Vehtari ◽  
Marcel Salive ◽  
Luigi Ferrucci
Keyword(s):  
Older Adults ◽  
Clinical Trials ◽  
Precision Medicine ◽  
Information Entropy ◽  
Late Life ◽  
Chronological Age ◽  
Biological Aging ◽  
Age Related ◽  
Body Organ ◽  
Aging Change

With aging, most older adults are at risk of having more than two diseases, conventionally defined as multimorbidity. We determined body organ disease number (BODN) as a new multimorbidity index. We measured the degree to which each disease level, from mild to severe, predicts longitudinal BODN uncoupled from chronological age. We determined Body Clock using global disease levels burden from all systems predicting longitudinal BODN for each individual, which is a proxy of the personalized rate of biological aging. Change in Body Clock predicts late-life age-related outcomes and can be used for geriatric clinics and clinical trials for precision medicine.

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