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Memory, Mood, and Marriage: Examining the Interplay in Older Adults [Editorial]

Lee, Ellen E; Balasubramaniam, Meera
PMID: 30120018
ISSN: 1545-7214
CID: 3241542

Rational Suicide in Elderly Adults: A Clinician's Perspective

Balasubramaniam, Meera
Geriatricians are increasingly encountering older adults expressing suicidal wishes in the absence of overt mental illness. This is expected to grow as life expectancy increases. This article describes the case of an older adult who expressed the wish to end his life in the absence of a diagnosable mental illness. Although he had chronic medical illnesses, he was not terminally ill. The complex subject of rational suicide in elderly adults is approached from a clinician's perspective. Issues of ageism, gerontophobia, and changing perspectives on death are highlighted. The experience of being a Baby Boomer and its influence on rational suicide is reviewed. Finally, clinical topics such as aging, frailty, dependence on younger and healthier individuals, and the older adult's need for a sense of control are explored.
PMID: 29500824
ISSN: 1532-5415
CID: 2979752

ETHICAL, LEGAL AND FORENSIC ISSUES IN GERIATRIC PSYCHIATRY [Meeting Abstract]

Gupta, Aarti; Balasubramaniam, Meera; Tampi, Rajesh
ISI:000432438300004
ISSN: 1064-7481
CID: 3132522

HIV-AIDS IN OLDER ADULTS [Meeting Abstract]

Mitra, Paroma; Balasubramaniam, Meera; Dhar, Romika; Chang, Beverly
ISI:000432438300045
ISSN: 1064-7481
CID: 3132512

ETHICAL, LEGAL AND FORENSIC ISSUES IN GERIATRIC PSYCHIATRY [Meeting Abstract]

Gupta, Aarti; Balasubramaniam, Meera
ISI:000397138000004
ISSN: 1545-7214
CID: 2528832

RATIONAL SUICIDE IN THE ELDERLY: MENTAL ILLNESS OR CHOICE? [Meeting Abstract]

McCue, Robert E.; Balasubramaniam, Meera; Kolva, Elissa; Nelson, Lawrence J.
ISI:000350829500059
ISSN: 1064-7481
CID: 2975372

Questions about an advance directive

Hammes, Bernard J; Harter, Thomas D; Balasubramaniam, Meera; Alici, Yesne
PMID: 24847704
ISSN: 1937-7010
CID: 1071472

Lewy Body Dementia: The Under-Recognized but Common FOE

Galvin, James E; Balasubramaniam, Meera
After Alzheimer's disease, Lewy body dementia (LBD) is the most prevalent progressive dementia of the many cognitive disorders wreaking unspeakable havoc on millions of lives. LBD is characterized by the presence of Lewy bodies, which are abnormal aggregates of a protein called alpha-synuclein, and are found in regions of the brain that regulate behavior, memory, movement, and personality. Many of the symptoms of Alzheimer's, Parkinson's, and LBD overlap, but LBD is more difficult to diagnose. Underdiagnosis is just part of the reason why LBD is unknown to the public and many health-care providers, and why funding for research lags far behind that for almost every other cognitive disorder.
PMCID:3999867
PMID: 24772233
ISSN: 1524-6205
CID: 1071482

Medroxyprogesterone acetate treatment for sexually inappropriate behavior in a patient with frontotemporal dementia

Balasubramaniam, Meera; Clark, Laura M; Jensen, T Patrick; Alici, Yesne
Limited information is available on efficacious therapies for the treatment of sexually inappropriate behavior (SIB) in individuals with frontotemporal dementia (FTD), despite its high prevalence. The authors present the case of an elderly male resident with FTD who was transferred to their state psychiatric facility from an assisted living facility because of concerns of worsening SIB. He was successfully treated with medroxyprogesterone acetate (MPA) after having an unsatisfactory response to a variety of psychopharmacologic agents and behavioral interventions. This case highlights the use of MPA as a safe and efficacious treatment for this behavior, and the authors provide recommendations for its use to target SIB in patients with FTD. The case also highlights the complementary role of behavioral interventions
ORIGINAL:0009174
ISSN: 1524-7929
CID: 1129922

Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders

Balasubramaniam, Meera; Telles, Shirley; Doraiswamy, P Murali
Background: The demand for clinically efficacious, safe, patient acceptable, and cost-effective forms of treatment for mental illness is growing. Several studies have demonstrated benefit from yoga in specific psychiatric symptoms and a general sense of well-being.Objective: To systematically examine the evidence for efficacy of yoga in the treatment of selected major psychiatric disorders.Methods: Electronic searches of The Cochrane Central Register of Controlled Trials and the standard bibliographic databases, MEDLINE, EMBASE, and PsycINFO, were performed through April 2011 and an updated in June 2011 using the keywords yoga AND psychiatry OR depression OR anxiety OR schizophrenia OR cognition OR memory OR attention AND randomized controlled trial (RCT). Studies with yoga as the independent variable and one of the above mentioned terms as the dependent variable were included and exclusion criteria were applied.Results: The search yielded a total of 124 trials, of which 16 met rigorous criteria for the final review. Grade B evidence supporting a potential acute benefit for yoga exists in depression (four RCTs), as an adjunct to pharmacotherapy in schizophrenia (three RCTs), in children with ADHD (two RCTs), and Grade C evidence in sleep complaints (three RCTs). RCTs in cognitive disorders and eating disorders yielded conflicting results. No studies looked at primary prevention, relapse prevention, or comparative effectiveness versus pharmacotherapy.Conclusion: There is emerging evidence from randomized trials to support popular beliefs about yoga for depression, sleep disorders, and as an augmentation therapy. Limitations of literature include inability to do double-blind studies, multiplicity of comparisons within small studies, and lack of replication. Biomarker and neuroimaging studies, those comparing yoga with standard pharmaco- and psychotherapies, and studies of long-term efficacy are needed to fully translate the promise of yoga for enhancing mental health.
PMCID:3555015
PMID: 23355825
ISSN: 1664-0640
CID: 1071492