title: Psychiatric and Medical Comorbidity in the Primary Care Geriatric Patient-An Update.
abstract: The mental health needs of older primary care patients are now widely recognized if not widely addressed. The range of behavioral health approaches including co-locating psychiatrists and integrating mental health professionals as care managers into primary care sites is extensive and growing. Nonetheless the primary care provider remains the first line of defense against mental disorders, most commonly depression and anxiety that accompany and exacerbate common physical conditions. The excess, potentially avoidable disability that results from comorbidity makes it imperative that early recognition and evidence based intervention occur. Multi-morbidity and polypharmacy make intervention a challenge. Psychotherapy can help overcome comorbidity depression however the most accessible intervention would be an antidepressant FDA approved for both anxiety and depressive disorders. For all these reasons, a focus on physical conditions most commonly associated with mental disorders can foster early recognition before the older patient's care becomes overwhelmingly complicated.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA. gkennedy@montefiore.org.|Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA. gkennedy@montefiore.org.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Kennedy
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Castro
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA.
authors.forename: Mason
authors.initials: M
authors.lastname: Chang
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA.
authors.forename: Jaimini
authors.initials: J
authors.lastname: Chauhan-James
authors.affiliation: Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
authors.forename: Manuel
authors.initials: M
authors.lastname: Fishman
mesh_terms: D000368:Aged; D003071:Cognition; D015897:Comorbidity; D061345:Early Medical Intervention; D015577:Geriatric Assessment / Q000379:methods; D054624:Health Status Disparities; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D011320:Primary Health Care / Q000379:methods*
keywords: Anxiety; Comorbidity; Dementia; Depression; Geriatric; Neurocognitive