Clinical psychology and anxiety and depression in dementia

Both depression and anxiety are common in dementia but there are many complicating bio-psychosocial factors which can make diagnosis and treatment difficult. There is a small but expanding literature on psychosocial treatment of depression in mild to moderate dementia but almost nothing on treatment of anxiety. Three cases, one involving an anxiety disorder, another involving someone with severe dementia, are presented to illustrate the nature of the work that clinical psychologists can undertake with this population and the skills and knowledge required. They are discussed with reference to standard therapeutic approaches versus a highly individualised case-specific approach, the need for collaboration with other disciplines, using carers or residential care staff as co-therapists and co-clients, working with nursing home staff to maximise compliance, and the need for clinical psychologists working with this population to be literate about medical and health issues.