Late-onset Depression and Mania: Diagnosis, Treatment and Life Events as Risk Factors

Late-onset depression and mania are associated with comorbidity, impaired functioning, and increased mortality. Discussion in literature is focused on the validity of late age at onset as a diagnostic distinction in geriatric patients. This issue is contrasted with possible age-associated effects on early-onset illness. Previous studies found that recognition and accurate diagnosis of late-life mood is challenging. Accordingly, the assessment of mood symptoms in elderly patients should focus on mood, anxiety, and cognitive and symptoms as well as on the assessment for comorbidities, use of new medications and adherence to prescribed medications.

A limited number of systematic studies on late-onset depression and mania are available. Accordingly, the primary aim of this Research Topic is to assess data regarding incidence, prevalence and clinical presentation of late-onset mood disorders. Aspects of psychopathology, course of illness, and outcomes including chronicity, mortality, and comorbidity need to be considered. One of the goals of the Research Topic is also to outline the treatment and management options available for late onset depression and mania, highlighting questions concerning response to mood stabilizers and in particular to lithium salts. Longitudinal investigations of late-onset depressed and manic patients are needed in order to study the effect of risk factors and identify predictors of outcome.

We will consider Original research, Reviews, Meta-analysis, Clinical Trials and Case reports addressing the following topics on late-onset depression and mania:

·      Prevalence, clinical correlates and associated factors;

·      Comorbidity conditions and differential diagnosis;

·      Psychopathology, course of illness and clinical outcome;

·      Risk factors and predictors;

·      Biomarkers and neurobiological pathways;

·      Treatment and management options available for more codified interventions;

·      Response to pharmacological treatment, in particular to mood stabilizers and lithium salts;

·      Response to somatic therapies (electroconvulsive therapy, transcranial magnetic stimulation, deep brain stimulation, etc);

·      Suicidal risk and prevention strategies.