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Objective: This study aimed to describe the clinical and psychiatric characteristics of older outpatients with bipolar disorder (BD), including psychiatric history (age of onset of symptoms, length of time with the illness, and number of psychiatric hospitalizations), mood state, and cognitive function. Methods: This was a cross-sectional study where clinical and demographic data were obtained by a psychiatric interview with each patient and family members as well as by a review of medical records. The sample consisted of 20 individuals aged 60 years or older with a diagnosis of BD type I according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Descriptive data analysis was performed, with categorical variables expressed as absolute and relative frequencies. Results: No patient had manic or depressive symptoms at the time of the evaluation; 15 (75.0%) had an early onset while 5 (25.0%) had a late onset of the disease. Nine patients (45.0%) showed no cognitive decline whereas 11 (55.0%) showed mild cognitive impairment. Conclusions: This study presents an understudied group of patients with BD. Considering the personal impact and burden on the health system related to this psychiatric condition, it is recommended that further studies be conducted in this area to better evaluate this growing population. (AU)

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We assessed psychotropic prescribing patterns in the clinical treatment of agitation and aggressive behavior in patients with Alzheimer's disease (AD) treated at specialist outpatient clinics in the Federal District of Brazil. This was a naturalistic, observational, multicenter study of a convenience sample of patients with AD (according to DSM-5) who had behavioral symptoms of aggression and/or agitation at outpatient visits, as assessed by the Neuropsychiatric Inventory (NPI), and required pharmacologic intervention. Participants were recruited in 2018-2019 from 11 AD treatment centers. Sociodemographic and clinical data were collected during routine visits. The sample consisted of 369 older adults with a mean age of 82.3 (SD, 7.7) years. The medications most commonly used in patients with behavioral disorders were antidepressants (79.1%), antipsychotics (70.2%), benzodiazepines (10.6%), and mood stabilizers (9.5%). Quetiapine was the most frequently prescribed antipsychotic medication (48.5%), at a mean dose of 57.4 (SD, 40.7) mg. Citalopram was the most widely used antidepressant medication (32.0%), at a mean daily dose of 24.1 (SD, 8.1) mg. In this sample, two or more pharmacologic agents were frequently used together to control aggression and agitation. Benzodiazepine was not frequently used.

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Objetivo. O trabalho consistiu em uma pesquisa para rastreamento de depressão em 35 idosos (10 homens e 25 mulheres) maiores de 60 anos, institucionalizados no Instituto de Gerontologia de Brasília. Método. Aplicou-se primeiramente o miniexame do estado mental para excluir idosos com demência. Dezessete (48,6%) foram excluídos por apresentarem índice compatível com quadro demencial. Nos dezoito restantes (51,4%), sendo treze mulheres e cinco homens, aplicou-se a Escala de Depressão Geriátrica de Yesavage em versão reduzida (EDG-15) para investigar prevalência de depressão dentro dessa população. Resultados. Do total de indivíduos incluídos na pesquisa, verificou-se que quatro (22,2%) tiveram índice menor que 5, ou seja, sem sintomas de depressão; quatorze (77,8%) apresentaram índice superior ou igual a 5, sendo suspeitos de depressão e destes, apenas dois (11,1%) tiveram índice maior ou igual a 11, sugerindo depressão grave, segundo o ponto de corte adotado pela EDG-15. Em relação ao sexo, das treze mulheres entrevistadas, onze (84,6%) apresentaram quadro depressivo comparados a apenas três homens (60%) dos cinco entrevistados. Os dois entrevistados que obtiveram índice maior que 11 (depressão grave) foram mulheres. Conclusões. A prevalência de depressão nesta amostra de idosos institucionalizados foi maior do que na população geral e o sexo mais acometido foi o feminino, estando compatível com dados encontrados na literatura.

Objective. This research was about a depression investigation in 35 seniors (10 men and 25 women), older than 60, living on Instituto de Gerontologia de Brasília. Method. First it was applied the mini mental state test to exclude seniors with demencial disorders. Seventeen (48.6%) seniors was excluded for presenting score compatible to dementia. In the remaining eighteen seniors (51.4%), it was applied the Yesavage Geriatric Depression Scale in its reduced version (GDS-15) to investigate depression occurrences inside this population. Results. From the patient’s total it was observed that four (22.2%) had a score less than 5, it means, without depression symptoms, fourteen of them (77.8%) had a score above or equal to 5, meaning they are suspicious of depression and just two of them (11.1%) had a score greater than or equal to 11, meaning a heavy depression state, conform GDS-15 cut point. Related to genre, from the thirteen women interviewed, eleven (84.6%) had depressive symptomathology against just three men (60%) from the five interviewed. The two seniors who had obtained score above 11 (heavy depression) was women. Conclusions. The prevalence of depression was much spread in this long-term care facility than in the population in general and the most affected gender was feminine, being compatible with the data found in the literature.

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