Mental Disorders in Older Adults: Fundamentals of Assessment and Treatment, 2nd Edition

Article excerpt

Geriatric Psychiatry Mental Disorders in Older Adults: Fundamentals of Assessment and Treatment, 2nd edition Steven H Zarit and Judy M Zarit. New York (NY): Guilford Press; 2006. 468 p. US$48.00.

Reviewer rating: Fair

The purpose of this book is to provide an overview of the assessment and treatment of mental disorders in later life. It was written for clinicians, students, and researchers. Psychosocial perspectives outlined in this book were meant to be useful to psychologists, social workers, nurses, and gerontologists. It was hoped that psychiatrists and geriatricians might find the presentation of behavioural and neuropsychological perspectives to be a useful complement to their biomedical approaches.

There are many areas of strength in the book including the chapters on assessment, psychological testing for differential diagnosis and capacity evaluations, family caregiving, consultation in institutional settings, and ethical issues. I found the sections that described the modification of cognitive therapy and interpersonal therapy for older adults to be thought-provoking. The ideas and approaches to family caregiving that are listed in the book are useful for those who provide care to older adults and their families.

I felt that the quality and quantity of the descriptions of the biological aspects of treatment (including such areas as mood stabilizers like lithium, atypical antipsychotics, and electroconvulsive therapy [ECT] as well as the integration of the biopsychosocial aspects of care) left room for improvement. My opinion is that it would not be worthwhile to read this book if one was intending to understand the complexities of the many different ways physicians, geriatricians, and geriatric psychiatrists take in providing care to their patients.

The sections in the book on medication and ECT do not seem to me to be as accurate and thorough as other review articles that have appeared in various medical journals. The use of lithium carbonate is only briefly mentioned and perhaps might reflect some of the practice patterns of some North American psychiatrists of using valproate as a mood stabilizer and avoiding lithium because of the potential side effects, cost of monitoring, and cost of caring for someone with lithium toxicity. …


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