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Pathophysiology of Alzheimer ’s Disease
Alzheimer ’s disease (AD) is the most common neurodegenerative disease leading to dementia worldwide. While neuritic plaques consisting of aggregated amyloid-beta proteins and neurofibrillary tangles of accumulated tau proteins represent the pathophysiologic hallmarks of AD, numerous processes likely intera ct with risk and protective factors and one’s culture to produce the cognitive loss, neuropsychiatric symptoms, and functional impairments that characterize AD dementia. Recent biomarker and neuroimaging research has revealed how the pathophysiology of AD may lead to symptoms, and as the pathophys iology of AD gains...
Source: The Psychiatric Clinics of North America - October 14, 2022 Category: Psychiatry Authors: Brandon C. Yarns, Kelsey A. Holiday, David M. Carlson, Coleman K. Cosgrove, Rebecca J. Melrose Source Type: research

Psychopharmacology in the Elderly
This article aims to discuss the common pharmacodynamic and pharmacokinetic changes associated with physiologic aging and their impacts on the use of psychotropic medications in the elderly. (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - October 14, 2022 Category: Psychiatry Authors: Kripa Balaram, Silpa Balachandran Source Type: research

Substance Use Disorders in the Elderly
The population of elderly in the United States with substance use disorders (SUDs) is growing appreciably. SUDs among the elderly are often associated with poor outcomes and are frequently underdiagnosed. The current diagnostic criteria are less sensitive in identifying SUDs among the elderly. Routine screening with validated screening tools may improve the diagnosis of SUDs among the elderly. There is a dearth of data from controlled studies on SUDs among the elderly and the use of pharmacologic agents for treatment, although data indicate that older adults with SUDs respond well to treatments that are specifically design...
Source: The Psychiatric Clinics of North America - October 14, 2022 Category: Psychiatry Authors: Rajesh R. Tampi, Deena J. Tampi, Alisandrea Elson Source Type: research

Comorbidity and Management of Concurrent Psychiatric and Medical Disorders
Aging increases susceptibility to medical and psychiatric comorbidity via interrelated biological, psychological, and social mechanisms. Mental status changes or other psychiatric symptoms occurring in older adults with medical disorders most often result from delirium, depression, or the onset of Alzheimer ’s disease and related dementias (ADRD). Clinicians can use evidence-based tools to evaluate such symptoms including the 4A’s Test for delirium, the Saint Louis University Mental Status Exam, and the Geriatric Depression Scale. Innovative models such as collaborative care can improve the outcome of care of older adu...
Source: The Psychiatric Clinics of North America - October 14, 2022 Category: Psychiatry Authors: Thomas A. Bayer, Ryan Van Patten, Dylan Hershkowitz, Gary Epstein-Lubow, James L. Rudolph Source Type: research

Geriatric Psychiatry Across the Spectrum
This article outlines geriatric psychiatry education in medical school, residency, and geriatric psychiatry fellowship with suggestions for recruitment into the field, along with recommendations for enhanced learning for general psychiatrists. (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - October 14, 2022 Category: Psychiatry Authors: Michelle L. Conroy, Kirsten M. Wilkins, Laura I. van Dyck, Brandon C. Yarns Source Type: research

Cognitive Impairment in Older Adults
Cognitive impairment and dementia affect dozens of millions of people worldwide and cause significant distress to patients and caregivers and a financial burden to families and health care systems. Careful history-taking, cognitive and physical examination, and supplemental neuroimaging and fluid-based biomarkers can accurately diagnose neurocognitive disorders. Management includes non-pharmacological and pharmacological treatments tailored to the etiology and to the individual. (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - October 14, 2022 Category: Psychiatry Authors: Nicol ás Pérez Palmer, Barbara Trejo Ortega, Pallavi Joshi Source Type: research

Epidemiology and Risk Factors for Dementia
In this article, the authors discuss primarily what is known about the epidemiology of all-cause dementia. Dementia is caused by a complex interplay of genetics, comorbidities, and lifestyle factors, and drug development has been challenging. However, evidence from large, prospective, observational studies has identified a variety of factors that may prevent or delay the onset of dementia. Several of these factors are modifiable and lend themselves to well to treatments currently available. The authors discuss the state of current evidence on dementia risk factors, the most promising avenues, and future directions for deme...
Source: The Psychiatric Clinics of North America - October 14, 2022 Category: Psychiatry Authors: Christina S. Dintica, Kristine Yaffe Source Type: research

Practical Considerations for Treating Comorbid Posttraumatic Stress Disorder in the Addictions Clinic
A practical, common-sense framework for recognizing and addressing comorbid posttraumatic stress disorder (PTSD) in the substance use disorder (SUD) clinic is outlined. The article focuses on strategies that can help establish trauma-informed care or augment an existing approach. Interventions are organized around the task of ameliorating shame (or shame sensitivity), which represents a transdiagnostic mediator of psychopathology and, potentially, capacity for change. Countershaming strategies can guide a trauma-responsive leadership approach. Considering the striking rate of underdiagnosis of PTSD among patients with SUD,...
Source: The Psychiatric Clinics of North America - August 31, 2022 Category: Psychiatry Authors: Benjamin Israel, Alicia E. Wiprovnick, Annabelle M. Belcher, Mary B. Kleinman, Avinash Ramprashad, Max Spaderna, Eric Weintraub Source Type: research

Thirty Years of The ASAM Criteria
The American Society of Addiction Medicine Criteria (ASAM) Criteria has profoundly influenced addiction treatment and reimbursement, with its growing toolkit of ASAM CONTINUUM software, ASAM-CARF Level of Care Certification Program, educational programs, and publications. A retrospective accounting shows that the field has made considerable strides, but has far to go. Providers and payers still need to (1) improve consistency in their use of standardized, multidimensional patient assessment; (2) improve flexibility in providing and reimbursing person-centered, individualized services; (3) improve measurement in treatment p...
Source: The Psychiatric Clinics of North America - August 31, 2022 Category: Psychiatry Authors: David R. Gastfriend, David Mee-Lee Source Type: research

Challenges and Advances in the Field of Addiction Psychiatry
Addiction Psychiatry is one of the very few fields in medicine where the disorders to be studied, understood, and treated keep growing in number rapidly. Many substances, behaviors, and technologies keep getting added to the mix of things to which people can develop a problematic addiction: social media, online gambling, or kratom are a few examples. (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - August 31, 2022 Category: Psychiatry Authors: Sunil Khushalani, George Kolodner, Christopher Welsh Tags: Preface Source Type: research

Addiction Psychiatry: Challenges and Recent Advances
PSYCHIATRIC CLINICS OF NORTH AMERICA (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - August 31, 2022 Category: Psychiatry Authors: Sunil Khushalani, George Kolodner, Christopher Welsh Source Type: research

Copyright
Elsevier (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - August 31, 2022 Category: Psychiatry Source Type: research

Contributors
HARSH K. TRIVEDI, MD, MBA (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - August 31, 2022 Category: Psychiatry Source Type: research

Contents
Sunil Khushalani, George Kolodner and Christopher Welsh (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - August 31, 2022 Category: Psychiatry Source Type: research

Forthcoming Issues
Geriatric Psychiatry (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - August 31, 2022 Category: Psychiatry Source Type: research