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Preface; References; Contents; Contributors; 1 Epidemiology of Older Age Bipolar Disorder; 1.1 Introduction; 1.2 Definition; 1.3 Limitations; 1.4 Prevalence in the Community; 1.5 Prevalence in Treatment Settings; 1.6 Age of Onset; 1.6.1 Bimodal Distribution; 1.6.2 Cutpoints and Proportionality of Early- Versus Late-Onset Bipolar Disorder in the Treatment Population; 1.7 Demographic Distinctions; 1.8 Heterogeneous Etiologies-Including Cerebrovascular Risk Factors and Secondary Mania; 1.9 Bipolar 1 Disorder Versus Bipolar 2 Disorder; 1.10 Natural History and Course of Illness
1.10.1 Initial Presentation1.10.2 Natural Course; 1.10.3 Increased Morbidity and Mortality; 1.10.4 Medical Comorbidity; 1.10.5 Psychiatric Comorbidity; 1.11 Summary; References; 2 Clinical Assessment of Older Adults with Bipolar Disorder; 2.1 Introduction; 2.2 Differential Diagnosis; 2.2.1 Mania and Physical Health; 2.2.2 Mania as a Symptom of Dementia; 2.2.3 Secondary Mania with a Neurological Cause; 2.2.4 Mania in the Context of Established Older Age Bipolar Disorder; 2.3 Assessment; 2.3.1 The Clinical Interview and History-Taking; 2.3.2 Risk Assessment; 2.3.3 Cognitive Assessment
2.4 Symptom Rating Scales2.4.1 Assessment of Comorbidities; 2.4.1.1 Psychiatric Comorbidities; 2.4.1.2 Recognizing and Assessing Somatic Comorbidities; 2.5 Summary and Directions for Future Research; References; 3 Neurobiology of Older Age Bipolar Disorder; 3.1 Introduction; 3.2 White Matter Hyperintensities, Vascular Risk, and Cognitive Function; 3.3 Volumetric Differences in Particular Regions of the Brain; 3.4 Diffusion Tensor Imaging; 3.5 Magnetic Resonance Spectroscopy; 3.6 Functional Neuroimaging: PET, SPECT, and fMRI; 3.7 Bipolar Disorder as a Neuroprogressive Disorder
3.7.1 Biomarkers of Oxidative Stress and Mitochondrial Dysfunction3.8 Clinical Implications Present and Future; 3.9 Summary and Conclusion; References; 4 Clinical Management of Older Age Bipolar Disorder; 4.1 Introduction; 4.2 Organizing Care; 4.3 Self-management, Psychoeducation, and Psychotherapy; 4.4 Drug Interactions and Tolerance; 4.5 Interactions of Drugs Frequently Used in Bipolar Disorder; 4.5.1 Lithium; 4.5.2 Valproate; 4.5.3 Carbamazepine; 4.5.4 Lamotrigine; 4.5.5 Antipsychotics; 4.6 Specific Pharmacotherapies and Electroconvulsive Therapy; 4.6.1 General Recommendations
4.6.2 Lithium4.6.2.1 Clinical Recommendations for Lithium Therapy; 4.6.3 Anticonvulsants; 4.6.3.1 Carbamazepine; 4.6.3.2 Valproate; 4.6.3.3 Lamotrigine; 4.6.3.4 Gabapentin; 4.6.3.5 Recommendations for Anticonvulsants; 4.6.4 Antipsychotics; 4.6.4.1 Recommendations for Antipsychotics; 4.6.5 Electroconvulsive Therapy; 4.6.6 Pharmacotherapy of Bipolar Depression; 4.6.7 Maintenance Pharmacotherapy; 4.7 Summary and Recommendations for Acute Bipolar Mania, Bipolar Depression, and Maintenance Therapy; References; 5 Older Age Bipolar Disorder and Substance Use; 5.1 Introduction
1.10.1 Initial Presentation1.10.2 Natural Course; 1.10.3 Increased Morbidity and Mortality; 1.10.4 Medical Comorbidity; 1.10.5 Psychiatric Comorbidity; 1.11 Summary; References; 2 Clinical Assessment of Older Adults with Bipolar Disorder; 2.1 Introduction; 2.2 Differential Diagnosis; 2.2.1 Mania and Physical Health; 2.2.2 Mania as a Symptom of Dementia; 2.2.3 Secondary Mania with a Neurological Cause; 2.2.4 Mania in the Context of Established Older Age Bipolar Disorder; 2.3 Assessment; 2.3.1 The Clinical Interview and History-Taking; 2.3.2 Risk Assessment; 2.3.3 Cognitive Assessment
2.4 Symptom Rating Scales2.4.1 Assessment of Comorbidities; 2.4.1.1 Psychiatric Comorbidities; 2.4.1.2 Recognizing and Assessing Somatic Comorbidities; 2.5 Summary and Directions for Future Research; References; 3 Neurobiology of Older Age Bipolar Disorder; 3.1 Introduction; 3.2 White Matter Hyperintensities, Vascular Risk, and Cognitive Function; 3.3 Volumetric Differences in Particular Regions of the Brain; 3.4 Diffusion Tensor Imaging; 3.5 Magnetic Resonance Spectroscopy; 3.6 Functional Neuroimaging: PET, SPECT, and fMRI; 3.7 Bipolar Disorder as a Neuroprogressive Disorder
3.7.1 Biomarkers of Oxidative Stress and Mitochondrial Dysfunction3.8 Clinical Implications Present and Future; 3.9 Summary and Conclusion; References; 4 Clinical Management of Older Age Bipolar Disorder; 4.1 Introduction; 4.2 Organizing Care; 4.3 Self-management, Psychoeducation, and Psychotherapy; 4.4 Drug Interactions and Tolerance; 4.5 Interactions of Drugs Frequently Used in Bipolar Disorder; 4.5.1 Lithium; 4.5.2 Valproate; 4.5.3 Carbamazepine; 4.5.4 Lamotrigine; 4.5.5 Antipsychotics; 4.6 Specific Pharmacotherapies and Electroconvulsive Therapy; 4.6.1 General Recommendations
4.6.2 Lithium4.6.2.1 Clinical Recommendations for Lithium Therapy; 4.6.3 Anticonvulsants; 4.6.3.1 Carbamazepine; 4.6.3.2 Valproate; 4.6.3.3 Lamotrigine; 4.6.3.4 Gabapentin; 4.6.3.5 Recommendations for Anticonvulsants; 4.6.4 Antipsychotics; 4.6.4.1 Recommendations for Antipsychotics; 4.6.5 Electroconvulsive Therapy; 4.6.6 Pharmacotherapy of Bipolar Depression; 4.6.7 Maintenance Pharmacotherapy; 4.7 Summary and Recommendations for Acute Bipolar Mania, Bipolar Depression, and Maintenance Therapy; References; 5 Older Age Bipolar Disorder and Substance Use; 5.1 Introduction