International Perspectives on Old Age Psychiatry Training.

Psychiatry of old age is a psychiatric subspecialty that has been developed in many countries since the 1950s as an attempt to improve the care of older adults with mental health disorders. Psychiatry of old age specialist training programs were subsequently established to develop a medical workforce that has the required competencies to work in this subspecialty. This article describes the psychiatry of old age specialist training programs in Australia, New Zealand, the United Kingdom, and Mexico. These training programs have varying durations, ranging from 1 to 3 years. Although it may not be a mandatory requirement to complete a psychiatry of old age clinical rotation, psychiatry of old age experience and competencies are expected during general psychiatry training. There is generally a lack of opportunity to learn about other clinical specialties relevant to older adults, such as geriatric medicine and neurology. Finally, much work is needed to better coordinate psychiatry of old age specialist training positions, workforce development, and service delivery to ensure there is a sufficient supply of psychiatry of old age specialists to meet the mental health needs of older adults in different countries in the coming years.

Novel approach to managing severely labile blood pressure during maintenance electroconvulsive therapy in a man with psychotic depression and Parkinson disease.

Electroconvulsive therapy cannot proceed safely unless blood pressure is within the reference range. Finding the cause of very high or low blood pressure can be very difficult, time consuming, and expensive. We suggest a more valid and reliable time to check blood pressure. This is highlighted in the case of a man that became riddled with iatrogenic complications and needless treatments.