RESUMO
Recent studies have demonstrated that older adults are more vulnerable to scams because of social isolation, economic affluence, mental disorders, struggles with technology, and cognitive impairments. In this report, we present the case of a 73-year-old man who fell victim to multiple scams over 8 years, leading to a loss of more than $100,000. We also discuss approaches to managing such patients in the outpatient setting. Susceptibility to scams is considered an increasing threat to the well-being of aging societies. The complexity of the problem and the scarcity of available studies make the management of such cases challenging for clinicians.
Assuntos
Envelhecimento , Psiquiatria Geriátrica , Masculino , Humanos , IdosoRESUMO
Major depressive disorder is a chronic and recurrent illness that affects 20% of adults during their lifetime and is one of the leading causes of suicide in the United States. A systematic measurement-based care approach is the essential first step in the diagnosis and management of treatment-resistant depression (TRD) by promptly identifying individuals with depression and avoiding delays in treatment initiation. As comorbidities may be associated with poorer outcomes to commonly used antidepressants and increase risk of drug-drug interactions, their recognition and treatment is an essential component of management of TRD.
Assuntos
Transtorno Depressivo Maior , Transtorno Depressivo Resistente a Tratamento , Adulto , Humanos , Estados Unidos , Depressão , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/tratamento farmacológico , Antidepressivos/uso terapêutico , Comorbidade , Transtorno Depressivo Resistente a Tratamento/diagnóstico , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológicoRESUMO
Treatment-resistant depression (TRD) affects one in three patients with major depressive disorder and is associated with increased risk of all-cause mortality. Studies of real-world practices suggest that antidepressant monotherapy continues to be the most widely used treatment after inadequate response to a first-line treatment. However, rates of remission with antidepressants in TRD are suboptimal. Atypical antipsychotics are the most widely studied augmentation agent and aripiprazole, brexpiprazole, cariprazine, quetiapine extended-release, and olanzapine-fluoxetine combination are approved for depression. Benefits of using atypical antipsychotics for TRD has to be weighted against their potential adverse events, such as weight gain, akathisia, and tardive dyskinesia.
