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At least 19 recordsLinked to original sources
PubMed1997

History of geriatric psychiatry in Israel.

This article describes the history of a relatively new branch in Israel's psychiatry, geriatric psychiatry. The unique features of Israel are described: a young country with an ancient history, uninterrupted migration waves, including the elderly strata, the reactivation of traumatic experiences in elderly Holocaust survivors and the impact of the security situation in particular on the elderly population. There is a growing awareness of the importance of geriatric psychiatry, in connection with the above features, with a quite rapid development of this branch in the country. Developing services are described, as are research projects and the contribution made by Israel's geriatric psychiatrists in the development of the field.

Geriatric Psychiatry↗
PubMed1993

Geriatric psychiatry: training guidelines and their application. Section on Geriatric Psychiatry of the Canadian Psychiatric Association.

Geriatric psychiatry is now a mandatory part of psychiatric residency education in Canada. Educational requirements in geriatric psychiatry were updated by the Royal College of Physicians and Surgeons of Canada in 1988, and guidelines were developed in more detail in 1989 by the Section on Geriatric Psychiatry of the Canadian Psychiatric Association (CPA). These guidelines are presented here together with a survey, conducted in the fall of 1991, of all 16 Canadian psychiatry residency programs. Thirteen of the training centres now require residents to have a formal rotation in geriatric psychiatry, generally three months in length. Residents are exposed to elderly patients in other services, such as consultation/liaison, but these services may not include formal teaching in geriatric psychiatry. Most programs have a seminar series in geriatric psychiatry and have training guidelines similar to those of the CPA. However, it is not clear how closely these are being followed, since it was felt in almost one-third of all programs that there was an insufficient number of teachers to fulfill the training requirements. In addition, a number of training directors felt that the objectives were too comprehensive to be met in the three month period. Earlier studies in the field are reviewed, implications of the current findings are discussed, and suggestions are made for further research.

Canada↗
PubMed1998

[Cholinesterase inhibitors for Alzheimer disease: preliminary recommendations for treatment. Dutch Society for Psychiatry, Section of Geriatric Psychiatry].

Several cholinesterase inhibitors have recently become available for Alzheimer's disease. To reach consensus about their relevance and use in daily practice, a meeting with clinical experts was organised by the section of Geriatric Psychiatry of the Dutch Society for Psychiatry. So far, available drugs have only very modest effects on cognitive functioning and clinical impression, compared with placebo. The question whether these effects are clinically relevant cannot be answered yet. Awaiting the results of further studies, it was decided not to use cholinesterase inhibitors on a routine basis but to limit prescription of these drugs to research setting or under well-controlled conditions with regard to diagnosis and evaluation. Furthermore, prescription must be limited to mild or moderately severe dementia caused by 'probable Alzheimer's disease'. Proper evaluation in the individual patient is still an unresolved problem. Therefore, n = I protocols are to be designed. These should include the use of appropriate and standardised instruments measuring cognitive functions, behavioural functions and activities of daily life. The skills and experience required will be available in specialised and multidisciplinary units for dementia. Pharmaceutical treatment for Alzheimer's disease must be integrated with all other available forms of patient care.

Aged↗
PubMed2006

Population pharmacokinetics in geriatric psychiatry.

Although geriatric patients are the major recipients of drugs, most research during drug development is conducted in healthy younger adults. Safe and effective drug therapy in the elderly requires an understanding of both drug disposition and response in older individuals. One of the major issues in studying the elderly relates to the ability to study a large number of people in a minimally invasive way. Population pharmacokinetics can be used to model drug concentrations from a large population of sparsely sampled individuals. Population pharmacokinetics characterizes both the interindividual (between-subject) and intraindividual (within-subject) variability, and can identify factors that contribute to pharmacokinetic and pharmacodynamic variability. Population pharmacokinetics can be used to aid in designing large clinical trials by simulating virtual data based on the study design. It can also be used to assess consistency of drug exposure and evaluate its effect on clinical outcome. This article reviews the methods used in pharmacokinetic modeling, as well as providing examples of population pharmacokinetic modeling, highlighting its application to geriatric psychiatry.

Adult↗
PubMed2003

Postgraduate diploma courses in geriatric psychiatry.

BACKGROUND: Training in geriatric psychiatry constitutes a fundamental element toward further development of this relatively new branch of medicine. However, it varies both in quantity and quality among different countries, healthcare providers and medical schools. OBJECTIVES: To describe the demographic and professional characteristics of participants in postgraduate diploma courses in geriatric psychiatry, and the perceived contribution of the courses, and to compare these variables among the participants in 1 year and 3 year courses, and between psychiatrists and non-psychiatrists. METHODS: A retrospective self-administered questionnaire was mailed to the 153 physicians who participated in the two courses. The 60 questionnaires completed and returned were analyzed. RESULTS: Participants in the courses constituted a heterogenous group in terms of demographic and professional characteristics, with no differences between 1 year and 3 year course participants, or between psychiatrists vs. non-psychiatrists (with the exception of more involvement of non-psychiatrists and 1 year course participants in old-age homes). Most responders indicated both the theoretical and practical benefits and application to daily practice of the material learned. Similarly, most responders indicated that after the courses they definitely used general assessment scales to a much greater extent, particularly cognitive scales, as well as operational diagnostic criteria for dementia. Participants in the 3 year course reported more significant use of assessment scales compared with 1 year participants, and 3 year participants and psychiatrists used the cognitive scales more often. There were no other significant differences between 1 year and 3 year participants and between psychiatrists' and non-psychiatrists' reports regarding general and more specific contributions of the courses. CONCLUSION: Postgraduate diploma courses in geriatric psychiatry seem to have a favorable effect on participants, irrespective of course duration or specialty. However, course duration positively influenced the implementation of assessment scales in general, and cognitive scales in particular. A prospective comparative study on this subject is warranted, with stricter definitions of participants' pre-course and postcourse background, attitudes, knowledge and benefits.

Adult↗
PubMed1994

Mandatory training in geriatric psychiatry: can programs deliver the goods?

There have been a number of recent attempts to establish guidelines and curricula for training of general psychiatry residents in geriatric psychiatry. However, concerns have arisen as to whether or not many training programs have the resources necessary to train residents using these guidelines. In an attempt to determine how closely training guidelines are adhered to, the Division of Geriatric Psychiatry at the University of Toronto anonymously surveyed all general psychiatry residents completing their mandatory training in geriatric psychiatry between June 1992 and July 1993 (N = 30). The supervisors of these residents were surveyed anonymously as well (N = 15). The response rate was 83% for the residents and 80% for staff. In general, the training guidelines were closely adhered to except possibly for the required number of patient contact hours per week. The author concludes that when training guidelines are developed which include consideration of appropriate program resources and the number of residents required to train, residents and supervisors adhere closely to these guidelines.

Aged↗