Julia Cromwell, MD

Clinical Update

Evidence-Based Options for Treatment-Resistant Depression in Older Adults

January 1, 2025

Julia Cromwell, MD. Medical director, geriatric and adult inpatient psychiatrist at Mass General Brigham Salem Hospital, Salem, MA.

Dr. Cromwell has no financial relationships with companies related to this material.

Treating depression in older adults can be challenging, especially when first-line therapies fail. We review evidence-based strategies for treatment-resistant depression, from medication adjustments and augmentation to neuromodulation and lifestyle interventions.

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Clinical Update

Causes of Psychosis in Older Adults

July 1, 2024

Julia Cromwell, MD and Christianne Gonzalez Davidson, MD

Julia Cromwell, MD. Medical Director, Senior Adult Psychiatry Unit, Salem Hospital, Salem, MA.

Christianne Gonzalez Davidson, MD candidate 2024. Tufts University School of Medicine, Boston, MA.

Late-life psychosis has many causes—we’ll walk you through this important differential.

Clinical Update

Failure to Thrive in Older Adults

April 1, 2024

Julia Cromwell, MD and Diana S. Kim, MD

Julia Cromwell, MD. Medical Director, Senior Adult Psychiatry Unit, Salem Hospital, Salem, MA.

Diana S. Kim, MD Candidate 2024. Tufts University School of Medicine, Boston, MA.

Dr. Cromwell and Ms. Kim have no financial relationships with companies related to this material.

Many older adults labeled with FTT eventually receive a medical diagnosis. Beyond addressing depression and treating the underlying medical illnesses, we suggest additional interventions to improve a patient’s functioning.

Clinical Update

Managing Insomnia in Older Adults

December 31, 2023

Julia Cromwell, MD

Julia Cromwell, MD. Medical Director, Senior Adult Psychiatry Unit, Salem Hospital, Salem, MA.

Dr. Cromwell has no financial relationships with companies related to this material.

Treating insomnia in older adults often comes with harms. Here we review how to get the diagnosis right, how to optimize treatment without medications, and how to find safer and more affordable medications when needed.

Clinical Update

Medical Mimics in Geriatric Psychiatry

July 11, 2023

Julia Cromwell, MD and Miranda Tsang

Miranda Tsang. MD candidate 2024, Tufts University School of Medicine, Boston, MA.

Julia Cromwell, MD. Medical Director, Senior Adult Psychiatry Unit, Salem Hospital, Salem, MA.

Ms. Tsang and Dr. Cromwell have no financial relationships with companies related to this material.

Medical illnesses can present with psychiatric symptoms— there are a few clinicians can’t afford to miss.

Clinical Update

Screening Tools, Assessment, and Brief Interventions for Substance Use Disorders in Older Adults

May 9, 2023

Julia Cromwell, MD

Julia Cromwell, MD. Inpatient geriatric psychiatrist, Mass General Brigham Salem Hospital, Salem, MA.

Dr. Cromwell has no financial relationships with companies related to this material.

How do you choose a screening tool for substance use disorders in older adults, and what do you do when a patient screens positive? We discuss common screening tools, assessments, and interventions based on an older adult’s risk level.

Clinical Update

Mania in Older Adults

January 31, 2023

Julia Cromwell, MD

Julia Cromwell, MD. Inpatient geriatric psychiatrist, Mass General Brigham Salem Hospital. Salem, MA. Dr. Cromwell has no financial relationships with companies related to this material.

In older adults, mania is more likely to be secondary to a medication or due to a neurological or
medical illness. We provide a mnemonic to help systematically think through the most likely
causes of secondary mania, which can help guide our workup.

How to Identify and Treat Apathy and Late-Life Depression

October 1, 2022

Rehan Aziz, MD and Julia Cromwell, MD

Rehan Aziz, MD. associate program director, geriatric psychiatry fellowship program, Jersey Shore University Medical Center; associate professor of psychiatry and neurology, Hackensack Meridian School of Medicine, Nutley, NJ. Julia Cromwell, MD. Inpatient geriatric psychiatrist, Mass General Brigham Salem Hospital, Salem, MA. Dr. Aziz and Dr. Cromwell, authors of this educational activity, have no relevant financial relationship(s) with ineligible companies to disclose.

We provide tips on distinguishing between apathy and depression, as well as recommendations on how to manage these disorders.