A large percentage of older adults must endure at least one chronic medical illness. Clinically significant depression and anxiety are common among these patients. Specific psychotherapy approaches as well as adaptations required to address the unique issues of this population have not been delineated in the literature. We outline a cognitive-behavioral therapy approach and discuss five treatment issues we have found to be important for this population. These issues include: (1) resolving practical barriers to participation; (2) accepting depression as a separate and reversible problem; (3) limiting excess disability; (4) counteracting the loss of important social roles and autonomy; and (5) challenging the perception of being a “burden.” A case study of a chronic obstructive pulmonary disease (COPD) patient with depression is presented and recommendations for future research are suggested.

During the course of four decades, the public health service—the system of walk in medical clinics (Polikliniks) and free health care services in the former German DemocraticRepublic (GDR)—had been favorably regarded. Only after reunification with the Federal Republic was it revealed with startling clarity that a myth had been cultivated by the West. Indeed, the equipment in the clinics, the educational level of physicians, and the health of the population put the public health service in a different light.

Although the central cholinergic deficits are still considered to be of primary importance in Alzheimer's disease, there is great need for an expansion of the pharmacological approach in this illness beyond the simple cholinergic replacement hypothesis. This report focuses on the concept of “combination chemotherapy” in Alzheimer's disease as the next generation of therapeutic strategies. Based on earlier positive findings in Alzheimer patients with the monoamine oxidase B inhibitor, 1-deprenyl, the authors speculate that a combination of physostigmine, the short-acting cholinesterase inhibitor, and 1-deprenyl might be more beneficial than either agent alone. The authors outline a sample paradigm for such combination studies, report preliminary data on the first 16 Alzheimer subjects to have received an initial combination of physostigmine and deprenyl, and point to other possible “combination chemotherapy” strategies for future study.

As recently as five years ago, ideas about developing effective treatments for Alzheimer's disease were at a theoretical level. However, within a short period of time the scientific knowledge about neurobiology of this disease has advanced very rapidly. With this new knowledge many groups in academia as well as pharmaceutical companies have designed, developed, and tested several different types of compounds.

The mental and physical capacities of all residents in psychiatric nursing homes in Bergen were studied. It was found that 95% were moderately or severely mentally impaired and 53% received antipsychotic medication regularly. By objective criteria, 47.9% were considered improperly placed. These patients typically had had a long stay in the institution, were immobile, and were given antipsychotic drugs infrequently.

Why does a company embark upon the funding of an award such as the IPA Awards? Is it fishing for publicity, is it charity, or is it an integral part of the company's research philosophy?

The authors present an overview of research questions related to psychopathology in elderly patients. Specific research questions in the areas of organic mental disorders, affective disorders, personality disorders, anxiety disorders, psychotic disorders, and substance abuse are presented. Clinical investigators are encouraged to pursue some of these specific questions in order to facilitate diagnosis and to develop specific effective treatment strategies for psychopathology in older patients.