Comorbidity and Management of Concurrent Psychiatric and Medical Disorders

Thomas A Bayer; Ryan Van Patten; Dylan Hershkowitz; Gary Epstein-Lubow; James L Rudolph

doi:10.1016/j.psc.2022.07.006

Comorbidity and Management of Concurrent Psychiatric and Medical Disorders

Psychiatr Clin North Am. 2022 Dec;45(4):745-763. doi: 10.1016/j.psc.2022.07.006. Epub 2022 Oct 14.

Authors

Thomas A Bayer¹, Ryan Van Patten², Dylan Hershkowitz³, Gary Epstein-Lubow⁴, James L Rudolph⁵

Affiliations

¹ Long-term Services and Supports Center of Innovation, Providence VA Medical Center, 353-373 Niagara St., Providence, RI 02907, USA; Division of Geriatrics and Palliative Medicine, Alpert Medical School of Brown University, 593 Eddy St., POB 438, Providence, RI 02903, USA. Electronic address: [email protected].
² Providence VA Medical Center, 830 Chalkstone Ave, Providence, RI 02908, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 593 Eddy Street, APC9 Providence, RI 02903, USA.
³ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 593 Eddy Street, APC9 Providence, RI 02903, USA.
⁴ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 593 Eddy Street, APC9 Providence, RI 02903, USA; Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 S. Main Street, Providence, RI 02903, USA; Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906, USA.
⁵ Long-term Services and Supports Center of Innovation, Providence VA Medical Center, 353-373 Niagara St., Providence, RI 02907, USA; Division of Geriatrics and Palliative Medicine, Alpert Medical School of Brown University, 593 Eddy St., POB 438, Providence, RI 02903, USA; Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 S. Main Street, Providence, RI 02903, USA.

PMID: 36396277
DOI: 10.1016/j.psc.2022.07.006

Abstract

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 adults with medical disorders requiring treatment for depression or ADRD..

Keywords: Co-occurring conditions; Collaborative care; Comanagement; Comorbidity; Geriatrics; Multimorbidity; Multiple chronic conditions; Psychiatry.

Published by Elsevier Inc.

Publication types

Review
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Aged
Alzheimer Disease*
Comorbidity
Delirium* / diagnosis
Humans