Screening measures such as the 15-item Geriatric Depression Scale (GDS-15) (Sheikh and Yesavage, 1986) and the Hospital Anxiety and Depression Scale (HADS) (Zigmond and Snaith, 1983) are important tools in the recognition of depressive symptoms in older people. While these measures are widely used, there is evidence of specific weaknesses in some cohorts and contexts, with the GDS-15 showing limitations in the context of cognitive impairment (Gilley and Wilson, 1997), and the depression subscale of the HADS (HADS-D) losing sensitivity in the context of older participants in hospital inpatient settings (Davies et al., 1993).

Background: Older adults with mental health disorders underutilize mental health services more than other adults. While there are well known general barriers to help seeking across the population, specific barriers for older adults include difficulties with transportation, beliefs that it is normal to be anxious and depressed in old age, and beliefs by referrers that psychological therapy is less likely to be effective. This study examined barriers related to identifying the need for help, seeking help and participating in therapy in a clinical population of older adults.

Method: Sixty older adults (aged 60–79 years) with comorbid anxiety and unipolar mood disorders completed barriers to treatment questionnaires before and after psychological group treatment, as well as measures of cognitive ability, anxiety, depression, and quality of life at baseline.

Results: The greatest barriers to help seeking related to difficulties identifying the need for help, with 50% of the sample reporting their belief that their symptoms were normal as a major barrier. Other major barriers identified were related to: self-reliance, cost of treatment, and fear of medication replicating previous findings. The main barriers reported for difficulties in continuing therapy included not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues.

Conclusions: The main barriers identified related to issues with identifying the need to seek help. More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to help seeking.

Clinical differentiation of Lewy body disease (LBD) from Alzheimer disease (AD) is still problematic. Many persons with LBD lack the cardinal features of visual hallucinations, fluctuations in cognition, and mild Parkinsonism proposed by McKeith et al. (2005). Some studies suggest that history or presence of depression may help distinguish LBD from AD, but this is confounded because many clinically diagnosed LBD patients have significant co-morbid AD pathology and vice versa (Ranginwala et al., 2008). We aimed to clarify whether history or symptoms of depression differentiate LBD from AD, in autopsy-confirmed patients, excluding patients with mixed AD and LBD pathology.

Self-care programs for depression use educational and cognitive-behavioral techniques (e.g. written information, audiotapes, videotapes, computerized, or group courses) to assist patients in the management of depressive symptoms (Morgan and Jorm, 2008). In the UK, these interventions are recommended as step 1 in a stepped care program for treating depression in primary care (National Institute for Health and Clinical Excellence, 2007). One meta-analysis suggests that supported self-care (self-care with coaching) is more effective than unsupported self-care (Gellatly et al., 2007).

Late-onset psychosis (LOP) has become increasingly prevalent in the clinical setting, especially in the highly aged society, due to the increasing numbers of older people and its disruptive impact on the lives of patients and caregivers. Although previous studies have identified some of the features of LOP (Webster and Grossberg, 1998; Mitford et al., 2010; Tan and Seng, 2012), some of the previous studies did not include patients with dementia and mood disorders. This study addresses the features of LOP in consecutive outpatients to provide information that supports the differential diagnosis.

Behavioral and Psychological Symptoms of Dementia (BPSD) are common in dementias but is a relatively new entity described in patients with Mild Cognitive Impairment (MCI). The International Psychogeriatric Association Consensus Group defines BPSD as “symptoms of disturbed perception, thought content, mood or behavior” (Coen et al., 1997). The present study was aimed at assessing the frequency of the same in patients with MCI.

This impressive collection of papers encompasses key themes at the heart of current research on anxiety in older adults, confirming that the study of anxiety in older adults has, indeed come of age (Beekman et al., 2015). The papers range from those providing in-depth exploration of an aspect of anxiety, such as the review by Hughes and colleagues of the concepts encompassed by the term “fear of falling” (Hughes et al., 2015), to those dealing with the assessment of anxiety, such as those by Mueller (Mueller et al., 2015) and Nitschke Massena (Nitschke Massena et al., 2015), while yet others address important issues in relation to anxiety treatment. This demonstrates the progress that has been made in recent years in our understanding and treatment of this significant group of disorders. I took a particular interest in reading these papers from the perspective of a clinician, and in this commentary will focus on themes and findings that I found to be of particular relevance to the mental health practitioner.

Early diagnosis of dementia enables early intervention and gives people the opportunity to make choices and plan for their future. Such an early diagnosis requires accurate assessment. A clinical assessment in people with suspected dementia in a memory clinic setting should include a clinical interview of the patient and their next of kin, a physical and neurological examination, cognitive assessment with appropriate cognitive tests, blood investigations, ECG (electrocardiography), and brain imaging.

The increased life expectancy in people with severe and persistent psychiatric illness, such as schizophrenia or bipolar disorder, has been predicted to substantially affect mental healthcare system (Bartels et al., 2002) that must adapt to meet the needs of older adults (Jeste et al., 1999). Development of specialized geriatric psychiatry services is thus needed.

Papers submitted to International Psychogeriatrics undergo peer review, with each manuscript being assessed by two or more reviewers possessing expertise relevant to the paper's topic. The advice of reviewers is often highly valuable to authors working to strengthen papers through revision, and their recommendations are central to the process of determining what is published in International Psychogeriatrics.

Mild cognitive impairment (MCI) is often defined as subjective memory complaints with intact activity of daily living without dementia. Its association as a precursor to Alzheimer's disease is well known. However, MCI in Parkinson's disease (PD) is poorly understood. The present small study aimed to measure the frequency of MCI and vascular factors in Indian patients with PD.