An admission to hospital can be extremely distressing, and a life-changing event. This is particularly true for older people with multiple co-morbidities and complex social needs. It is perhaps unsurprising, then, that mood disorders are common in older people in hospital. A mood disorder can also precipitate a hospital admission, for instance through self-neglect or self-harm. When in hospital, altered mood states can impact a person’s ability to engage with the treatment and are associated with worse outcomes.

This chapter describes the prevalence and aetiology of depression, mania, and their associated disorders in a general hospital setting. It goes on to consider the challenges of assessment in this environment, in particular the impact of the admission, morbidity, and medical interventions on a person’s mood state.

It concludes by describing non-pharmacological and pharmacological treatment strategies for managing elevated and depressed mood in a hospital setting, where people may be physically compromised and the environment may not be ideal for meaningful therapeutic engagement.