Journal of Religion and Health

, Volume 32, Issue 2, pp 131–151 | Cite as

Trends in geriatric psychiatry relevant to pastoral counselors

  • Harold G. Koenig
Article

Abstract

This article is a general overview of mental disorders in the aged that stresses the complementary roles that religious and mental health professionals can play in meeting the psychological and spiritual needs of elders. Chaplains and pastoral counselors should be competent in recognizing serious psychiatric disorders in older adults and able to differentiate them from the more common and benign emotional disturbances. Both counseling and biological treatments have distinct but often overlapping roles in the treatment of mental disorders in the aged. When treating emotionally disturbed elders, religious professionals should be aware of new trends in psychotherapy and biological psychiatry that are now making the integration of secular and religious techniques more and more feasible.

Keywords

Mental Health Health Professional Mental Disorder Psychiatric Disorder Mental Health Professional 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Meehan, P.J., Saltzman, L.E., Sattin, R.W., “Suicides Among Older United States Residents: Epidemiologic Characteristics and Trends,”American J. Public Health, 1991,81, 1198–1200.Google Scholar
  2. 2.
    Diagnostic and Statistical Manual, 3rd edition, revised. Washington, DC, American Psychiatric Press, 1987.Google Scholar
  3. 3.
    Derogatis, L.R., Morrow, G.R., Fetting, J., Penman, D., Piasetsky, S., Schmale, A.M., Henrichs, M., Carnicke, C.L.M., “The Prevalence of Psychiatric Disorders Among Cancer Patients,”J. American Medical Association, 1983,249, 751–757; Koenig, H.G., Meador, K.G., Shelp, F., Goli, V., Cohen, H.J., Blazer, D.G., “Major Depressive Disorder in Hospitalized Medically Ill Patients: An Examination of Young and Elderly Male Veterans,”J. American Geriatrics Society, 1991,39, 881–890.Google Scholar
  4. 4.
    Koenig, H.G., Meador, K.G., Cohen, H.J., Blazer, D.G., “Depression in Elderly Hospitalized Patients with Medical Illness.”Archives of Internal Medicine, 1988, 148, 1929–1936; Koeniget al., “Major Depressive Disorder in Hospitalized Medically Ill Patients: An Examination of Young and Elderly Male Veterans,”op. cit., pp. 881–890.Google Scholar
  5. 5.
    Weissman, M.M., Leaf, P.J., Tischler, G.L., Blazer, D.G., Karno, M., Bruce, M.L., Florio, L.P., “Affective Disorders in Five United States Communities,”Psychological Medicine, 1988,18, 141–153.Google Scholar
  6. 6.
    Koenig, H.G,et al., Meador, K.G., Cohen, H.J., Blazer, D.G. “Depression in Elderly Hospitalized Patients with Medical Illness,”op. cit., pp. 1929–1936.Google Scholar
  7. 7.
    Parmelee, P.A., Katz, I.R., Lawton, M.P. Depression Among Institutionalized Aged: Assessment and Prevalence Estimation.J Gerontology, 1989,44, M22-M29; Weissman, M.M., Bruce, M.L., Leaf, P.J., et al., “Affective Disorders.” In Robins, L.N., Regier, D.A., eds.,Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York, Free Press, 1991, p. 53.Google Scholar
  8. 8.
    Koenig, H.G., Blazer, D.G., “Mood Disorders and Suicide.” Chapter 14, in Birren, J.E., ed.,Handbook of Mental Health and Aging. New York, Academic Press, 1992, pp. 379–407.Google Scholar
  9. 9.
    Osgood, N.J., “Prevention of Suicide in the Elderly,”J. Geriatric Psychiatry, 1991,24, 293–306.Google Scholar
  10. 10.
    Humphry, D.,Final Exit. Eugene, Oregon, The Hemlock Society, 1991.Google Scholar
  11. 11.
    Callahan, D.,Setting Limits. New York, Simon & Schuster, 1987.Google Scholar
  12. 12.
    Osgood, N.J, “Prevention of Suicide in the Elderly,”op. cit., pp. 293–306.Google Scholar
  13. 13.
    Orentlicher, D., “Physician Participation in Assisted Suicide,”J. American Medical Association, 1989,262, 1844–1845; Teno, J., Lynn, J., “Voluntary Active Euthanasia: The Individual Case and Public Policy,”J. American Geriatrics Society, 1991, 39, 827–830; Conwell, Y., Caine, E.D., “Rational Suicide and the Right to Die,”New England J Medicine, 1991, 325, 1100–1103; Watts, D.T., Howell, T., Priefer, B.A., “Geriatricians' Attitudes toward Assisting Suicide of Dementia Patients,”J. American Geriatrics Society, 1992, 40, 878–885.Google Scholar
  14. 14.
    Cassell, C.K., Meier, D.E., “Morals and Moralism in the Debate Over Euthanasia and Assisted Suicide,”New England J Medicine, 1990, 323, 750–752; Jecker, N.S., “Giving Death a Hand: When the Dying and the Doctor Stand in a Special Relationship,”J. American Geriatrics Society, 1991,39, 831–835; Quill, T.E., “Death and Dignity: A Case of Individualized Decision Making,”New England J. Medicine, 1991,324, 691–694.Google Scholar
  15. 15.
    Hamm, R.J., Lyeth, B.G., “Nociceptive Thresholds Following Food Restriction and Return to Free-Feeding,”Physiology & Behavior, 1984,33, 499–501; Hamm, R.J., Knisely, J.S., Watson, A., Lyeth, B.G., Bossut, F.B., “Hormonal Mediation of the Analgesia Produced by Food Deprivation,”Physiology & Behavior, 1985,35, 879–882.Google Scholar
  16. 16.
    Wennberg, R.N.,Terminal Choices: Euthanasia, Suicide, and the Right to Die. Grand Rapids, Mich, Eerdman's Publishing Co, 1989.Google Scholar
  17. 17.
    Brown, J.H., Henteleff, P., Barakat, S., Rowe, C.J., “Is it Normal for Terminally Ill Patients to Desire Death?”American J. Psychiatry, 1986, 143, 208–211; Conwell and Caine, “Rational Suicide and the Right to Die,”op. cit., 1100–1103.Google Scholar
  18. 18.
    Meehan, P.J.et al., Saltzman, L.E., Sattin, R.W., “Suicides Among Older United States Residents: Epidemiologic Characteristics and Trends,”op. cit., pp. 1198–1200.Google Scholar
  19. 19.
    Weissman,et al., “Affective Disorders,”op. cit., p. 53.Google Scholar
  20. 20.
    Reisberg, B., Ferris, S.H., de Leon, M.J.,et al., “The Global Deterioration Scale for Assessment of Primary Degenerative Dementia,”American J. Psychiatry, 1982,139, 1136–1139.Google Scholar
  21. 21.
    Evans, D.A., Funkenstein, H., Albert, M.,et al., “Prevalence of Alzheimer's Disease in a Community Population of Older Persons,”J. American Medical Association, 1989,262, 2551–2556.Google Scholar
  22. 22.
    Meng, H., Freud, E.L.,Psychoanalysis and Faith: The Letters of Oskar Pfister. London, The Hogarth Press, 1963.Google Scholar
  23. 23.
    Seamands, D.A.,Healing of Memories. Wheaton, Ill, SP Publications (Victor Books), 1985.Google Scholar
  24. 24.
    Horney, K.,Neurosis and Human Growth. New York, Norton, 1950; Fromm-Reichman, F.,Principles of Intensive Psychotherapy. Chicago, University of Chicago Press, 1950; Sullivan, H.S.,The Interpersonal Theory of Psychiatry. New York, Norton, 1953; Bonime, W.,Clinical Use of Dreams. New York, Basic Books, 1962.Google Scholar
  25. 25.
    Hine, F.R., Pfeiffer, E.,et al., Behavioral Science: A Selective View. Boston, Little, Brown, & Co., 1972.Google Scholar
  26. 26.
    Guntrip, H.,Psychoanalytic Theory, Therapy, and the Self. New York, Basic Books, 1971; Wachtell, P.,Psychoanalysis and Behavioral Therapy: Toward an Integration. New York, Basic Books, 1977.Google Scholar
  27. 27.
    Schafer, R.,A New Language for Psychoanalysis. New Haven, Yale University Press, 1976, pp. 3–15, 194–211.Google Scholar
  28. 28.
    Beck, A.T.,Cognitive Therapy and Emotional Disorders. New York, International Universities Press, 1976.Google Scholar
  29. 29.
    Gallagher, D.E., Thompson, L.W., “Effectiveness of Psychotherapy for Both Endogenous and Nonendogenous Depression in Older Adult Outpatients,”J. Gerontology, 1983,38, 707–712; Gottlieb, G., Beck, A.T., “Cognitive Therapy and Pharmacotherapy in Geriatric Depressants: A Pilot Random Clinical Trial,” paper presented at 140th Annual Meeting of American Psychiatric Association, Chicago, 1987; Thompson, L.W., Gallagher, D., Breckenridge, J.S., “Comparative Effectiveness of Psychotherapies for Depressed Elders,”J. Consulting & Clinical Psychology, 1987,55, 385–390.Google Scholar
  30. 30.
    Cautella, J.R., Mansfield, L.A., “Behavioral Approach to Geriatrics.” In Gentry, W.D., ed,Geropsychology: A Model of Training and Clinical Service. Cambridge, Mass., Balinger Press, 1977, pp. 21–42; Mishara, B.L., “Geriatric Patients Who Improve in Token Economy and General Milieu Treatment Programs: A Multivariate Analysis,”J. Consulting & Clinical Psychology, 1978,46, 1340–1348; Gallagher, D., Thompson, L.W., “Differential Effectiveness of Psychotherapies for the Treatment of Major Depressive Disorder in Older Adult Patients,”Psychotherapy: Theory, Research and Practice, 1982,19, 42–49.Google Scholar
  31. 31.
    Probst, L.R.,Psychotherapy in a Religious Framework: Spirituality in the Emotional Healing Process. New York, Human Sciences Press, 1987.Google Scholar
  32. 32.
    Probst, L.R., “The Comparative Efficacy of Religious and Non-religious Imagery for the Treatment of Mild Depression in Religious Individuals,”Cognitive Therapy & Research, 1980,4, 167–178.Google Scholar
  33. 33.
    Backus, W., Chapian, M.,Telling Yourself the Truth. Minneapolis, Minn, Bethany Fellowship, 1980.Google Scholar
  34. 34.
    Miller, W.R., Martin, J.E.,Behavior Therapy and Religion: Integrating Spiritual and Behavioral Approaches to Change. Newbury Park: Sage Publications, 1988.Google Scholar
  35. 35.
    Hine, F.R., “Improvement of Emotional Support Through Differential Diagnosis of Inner Conflict,”Psychosomatics, 1963,4, 191–198; Werman, D.,The Practice of Supportive Psychotherapy. New York, Brunner-Mezel, 1984.Google Scholar
  36. 36.
    Koenig, H.G., Breitner, J.C.S., “Use of Antidepressants in Medically Ill Older Patients. A Review and Commentary,”Psychosomatics, 1990, 31, 22–32.Google Scholar
  37. 37.
    Koenig, H.G., “Electroconvulsive Therapy for Treatment of Depression in Older Patients,”Geriatric Consultant, 1991,9 (5), 14–16.Google Scholar
  38. 38.
    Koenig, H.G., Cohen, H.J., Blazer, D.G., Pieper, C., Meador, K.G., Shelp, F., Goli, V., DiPasquale, R., “Religious Coping and Depression in Older Hospitalized Medically Ill Men,”American J. Psychiatry, 1992,149, 1693–1700.Google Scholar
  39. 39.
    Idler, E.L., “Religious Involvement and the Health of the Elderly: Some Hypotheses and an Initial Test,”Social Forces, 1987,66, 226–238; Koenig, H.G., Kvale, J.N., Ferrel, C., “Religion and Well-being in Later Life,”Gerontologist, 1988,28, 18–28; Pressman, P., Lyons, J.S., Larson, D.B., Strain, J.J., “Religious Belief, Depression, and Ambulation Status in Elderly Women with Broken Hips,”American J. Psychiatry, 1990,147, 758–760; Idler, E.L., Kasl, S.V., “Religion, Disability, Depression, and the Timing of Death,”American J. Sociology, 1992, in press.Google Scholar
  40. 40.
    Koenig, H.G.,Aging and God: Spiritual Pathways to Mental Health in Midlife and the Later Years. New York, Haworth Press, 1993.Google Scholar

Copyright information

© Institutes of Religion and Health 1993

Authors and Affiliations

  • Harold G. Koenig
    • 1
  1. 1.Geriatric Evaluation and Treatment Clinic at Duke University Medical Center in DurhamNorth Carolina

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