bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical phenomena of Charlevoix-Saguenay ataxia in two adult brothers
Authors: Verhoeven W.M.A. , Egger J.I.M. , Ahmed A.I.A. , Kremer B.P.H. , Vermeer S. , van Warrenburg B.P.C.
Published: May 2011

Introduction

Autosomal recessive ataxia of Charlevoix-Saguenay (ARSACS) is characterized by early onset cerebellar ataxia, lower limb spasticity, and sensorimotor axonal polyneuropathy. Early atrophy of the superior cerebellar vermis is always present. Molecular linkage analysis found that the ARSACS gene is located on chromosome 13q12. Cloning of the gene, SACS, demonstrated that it encodes the protein sacsin.

Objectives

Systematic evaluation of neurological, neuropsychiatric and neuropsychological features in two male siblings.

Aims

Investigation of the putative relationship between cerebellar dysfunction and affective symptoms.

Methods

Detailed neuropsychiatric and neuropsychological assessment.

Results

The first patient, aged 55, the disease started in early infancy and a severe progressive cerebellar syndrome with spasticity of the legs and axonal polyneuropathy developed. In his brother, aged 50, the debut of neurological symptoms was in preadolescence with a less severe deterioration over time. Cognitive functioning was only marginally impaired in the latter patient, whereas behavioural aberrations were present in the first patient only. Both patients showed a reduced cognitive and emotional responsivity to environmental events leading to impairments in several areas of daily life, such as lack of effort and strategic planning, as well as impulsivity and impoverished social interaction with emotional indifference. This symptom profile typically points towards the presence of an apathy syndrome.

Conclusions

In ARSACS, in addition to the motor impairments, it may be postulated that the cerebellar cognitive affective syndrome is present. Thus, this hereditary form of ataxia may be accompanied by a series of non-motor symptoms of which motivational and affective signs dominate. \
Kleefstra syndrome: neuropsychiatric sequelae
Authors: Verhoeven W.M.A. , Kleefstra T. , Egger J.I.M.
Published: May 2011

Introduction

Submicroscopic deletions of the distal long arm of chromosome 9q are relatively common and give rise to a clinically recognizable phenotype referred to as the Kleefstra Syndrome [OMIM 610253]. It was shown that haploinsufficiency of the EHMT1 (Euchromatic Histone Methyltransferase 1) gene is responsible for the core phenotype by identifying cases with intragenic EHMT1 loss of function mutations. Key features of the syndrome are mental retardation, childhood hypotonia and facial dysmorphisms. Congenital heart and renal defects, microcephaly, epilepsy, and behavioural problems are frequently present.

Objectives

Description of the developmental, behavioural and neuropsychiatric characteristics in 4 middle aged patients with recently diagnosed Kleefstra syndrome

Aims

Contributing to the putative behavioural phenotype of Kleefstra syndrome.

Methods

Detailed neuropsychiatric and neuropsychological assessment.

Results

In the 4 patients, conventional cytogenetic investigation showed normal karyotypes. With routine subtelomeric MLPA and additional 9q regional specific MLPA tests, a submicroscopic deletion of the long arm of chromosome 9 (9q34.3) was found. Both deletions comprised the EHMT1 gene, in agreement with the diagnosis of Kleefstra syndrome. In all patients a severe apathy and a marked dyssomnia were present. Although some motor symptoms could be assessed with a catatonia rating scale, these have to be considered as a consequence of the apathy and belong therefore not to the catatonic spectrum.

Conclusions

Kleefstra syndrome is constituted, in addition to its distinct phenotypic features, by a specific behavioural phenotype that comprises, apart from the absence of speech development, a specific sleep disturbance and severe apathy from the third decade on.
Behavioural phenotype of noonan syndrome in adulthood
Authors: Wingbermuehle E. , Egger J.I.M. , van der Burgt I. , Verhoeven W.M.A.
Published: May 2011

Introduction

Noonan syndrome (NS) is an autosomal dominant genetic disorder with an estimated incidence of 1:1,500 live births and is characterized by short stature, facial dysmorphisms and congenital heart defects. At present, mutations in seven different genes have been identified. NS is associated with impaired affective processing and subsequently increased levels of anxiety.

Objectives

Neuropsychological investigation of social cognition.

Aims

The use of neuropsychological assessment as a tool for studying the contribution of cognition and behaviour to the expression of the Noonan phenotype.

Methods

Forty adult NS-patients and a matched group of healthy controls underwent extensive neuropsychological assessment. Next to the standard cognitive domains (i.e. intelligence, attention, memory, executive functioning) several tests for social cognition were included to explore affective information processing. Correlation analysis and repeated measures MANCOVA were used.

Results

Marked problems were found in the recognition of own and other's emotions, as well as in the ability to verbally express feelings. Alexithymia was significantly more prevalent in the NS-group. In addition, NS-patients displayed more mood and anxiety complaints than controls. A tendency was found to social desirability and agreeableness.

Conclusions

Impairments in social cognition are common elements of NS behavioural phenotype in adults. With neuropsychological assessment, psychosocial immaturity, amenable traits and alexithymia could be identified. The latter increases the vulnerability for the development of mood and anxiety disorders.
TPH2 Polymorphisms and alcohol-related suicide
Authors: Videtič Paska A. , Zupanc T. , Pregelj P. , Tomori M. , Komel R.
Published: May 2011

Introduction

Substantial evidence from family, twin, and adoption studies corroborates implication of genetic and environmental factors, as well as their interactions, on suicidal behavior and alcoholism risk. Serotonergic disfunction seems to be involved in the pathophysiology of substance abuse, and has also an important role in suicidal behavior.

Objectives

Recent studies of the tryptophan hydroxylase 2 (TPH2) showed mild or no association with suicide and alcohol-related suicide.

Aims

Investigation of the role of five single nucleotide polymorphisms (SNPs), one functional (p.Arg441His), two in intron 5 (Rs1843809, Rs1386493), and two in the 5’ regulatory promoter region (Rs4131348, Rs11178997) of TPH2, in association with suicide and alcohol-related suicide on a population with one of the highest suicide rates in the world.

Methods

We performed qRT-PCR (Real-Time Polymerase Chain Reaction) genotyping analysis of SNPs and alcohol analysis on 388 suicide victims and 227 controls.

Results

The results showed association between suicide (P(X2) = 0.043) and alcohol-related suicide (P(X2) = 0.021) for SNP Rs1843809. A tendency for association was determined also for polymorphism Rs1386493 (P(X2) = 0.055) and alcohol-related suicide. Data acquired from psychological autopsies in a subsample of suicide victims (n = 79) determined more impulsive behavior (P(X2) = 0.016) and verbal aggressive behavior (P(X2) = 0.025) in the subgroup with alcohol misuse or dependency.

Conclusions

Our results suggest implication of polymorphisms in suicide and alcohol-related suicide, but further studies are needed to clarify the interplay among serotonergic system disfunction, suicide, alcohol dependence, impulsivity and the role of TPH2 enzyme.
BDNF Val66Met modulates 5-HTTLPR for develop neuroticism in borderline personality disorder
Authors: Villarroel Garrido J. , Silva Ibarra H. , Iturra Constant P. , Jerez Concha S. , Montes Aguirre C. , Fuentes Salgado M. , Bustamante Calderon M.L.
Published: May 2011

Brain derived neurotrophic factor (BDNF) is the most widely distributed and highly expressed neurotrophin in the CNS. BDNF gene have been associated with increased risk psychiatric disorders. It has been described interaction between BDNF and serotonin system at a neural and genetic level. Neuroticism as a personality trait relevant in borderline personality disorder (BPD) has genetic inheritance and is associated with serotonergic dysfunction. Has been reported that BDNF Val66Met variant is associated with neuroticism in general population. The aim of this study is to test the association between Val66Met and neuroticism and evaluate if the presence of Val66Met allele interacts with polymorphism in promoter region of serotonin transporter gene (5-HTTLPR) for develop neuroticism in BPD. We evaluate personality with NEO PI R in 104 BPD subjects that did not meet criteria for axis I diagnoses and other personality disorders. Genetic analysis of BDNF was performed determining the presence of Val/Val Val/Met and Met/Met BDNF variants. 5-HTTLPR was performed determining the presence of L and S 5-HTTLPR alleles. Statistical analysis were tested with parametric and correlation method with Stata10. We did not found differences in neuroticism between BDNF variants, but when controlled by BDNF alleles we found that Met/Met modulate the expression of 5-HTTLPR, with S-carriers (LS+SS) having higher neuroticism than LL (F = 6.36, p = 0.0031). We found no differences in expression of 5-HTTLPR in other BDNF variants. We conclude that BDNF have a differential modulating effect of 5-HTTLPR in neuroticism in BPD.
Memory effect as if a group of self-esteem, mental health quality of life elderly
Authors: Ahmadi Gatab T.
Published: May 2011

Introduction

Older people with special challenges such as increased chronic problems reduced financial resources and reduced functional abilities have encountered.

Objectives

This study group as if the memory effect on self-esteem, mental health and quality of life for elderly people has been done.

Methods

Research methods, experimental. Statistical Society Research Babol are elderly. Sample aged 60 to cluster all the city neighborhoods selected randomly into two experimental groups (30 patients) and control (n = 30) groups. Then each of the experimental and control groups also were divided into six groups. Seniors in the experimental group meetings as if the memory control group, but group sessions in eight sessions and each session for one and a half hours they attended.

Results

The results show that the experimental group participated in group meetings as if the memory than the control group who participated in group sessions, having self-esteem, mental health and quality of life are at a high level. The results also show that the mental health subscales (physical impairment, impaired social function, anxiety and depression) compared to the experimental group had better control of the situation.

Conclusions

Seniors expressed their memories in a group, their positive and negative emotions poured out, and now that this reconciliation will lead to attitude change are elderly. On the other hand seems to have an active role in memory leads to increased confidence and improving mental health and sense of usefulness and the elderly are a result of depression and anxiety decreased.
Screening for depression in nursing homes: Validity of the WHO (Five) Well-Being Index
Authors: Allgaier A.-K. , Liwowsky I. , Kramer D. , Mergl R. , Fejtkova S. , Hegerl U.
Published: May 2011

Introduction

Depression is common in nursing home residents, but is still underrecognized. Screening for depression could be a first step to increase recognition rates within this high-risk group.

Objectives

Therefore, we investigated the validity of the WHO (Five) Well-Being Index (WHO-5) for early detection of depression in nursing home residents.

Methods

The Structural Clinical Interview for DSM-IV (SCID) was used as the gold standard for the validation of the WHO-5. The diagnoses covered in this assessment were both current major depression (MD) as well as minor depression (MinD) according to DSM-IV research criteria.

Results

In our sample of 92 nursing home residents in Munich aged 65–97 years, (73.9% female, 26.1% male) 14.1% fulfilled the criteria of MinD, and again 14.1% fulfilled the criteria of MD in the SCID. Overall diagnostic validity (area under the ROC curve) of the WHO-5 was 90.1% (95% confidence interval: 83.5%–96.7%). The World Health Organization's recommended cut-off-point of 13 yielded a sensitivity of 92.3% for the category of ‘MinD or MD’, and a specificity of 74.2%. Corresponding values for an adapted cut-off point of 12 are 92.3% and 78.7%, respectively.

Conclusions

The diagnostic accuracy of the WHO-5 in our study is promising. The WHO-5 might be an efficient screening tool for nursing home residents, especially with the adapted cut-off point, but results have to be replicated in a larger sample.
Poststroke depression in elderly, a review
Authors: Samakouri M. , Arseniou S. , Keskeridou F.-G. , Gymnopoulou M. , Livaditis M.
Published: May 2011

Introduction

Mood disturbances are often found in stroke patients and have a negative impact both on the recovery and the outcome of the stroke. Depression is the most common neuropsychiatric complication in the poststroke population, affecting nearly 30%–50% of patients within the first year. PSD implies a significant burden on both patients and their caregivers.

Material and methods

Using the search engines Pubmed and Scopus, 20 papers regarding the elderly dated from 2002–2010 were reviewed using the keywords depression, poststroke, recovery after stroke.

Results

The core features of PSD include but are not limited to: persistent sadness, feelings of hopelessness, helplessness and worthlessness, guilt and sense of being a burden on the caregiver, lack of motivation, loss of interest, death wishes and suicidal ideation. Various cerebrovascular risk factors, including hypertension, atherosclerotic heart disease, hyperlipidemia and diabetes mellitus have been implicated as risks for depression in late life.

Other predisposing factors are: prior history of depression or anxiety disorder, certain personality traits, baseline dementia but also, social isolation, living alone, physical functional impairments or a history of other psychiatric disorder.

Conclusion

Depression may impede recovery from stroke and impair outcome by affecting social functioning, motor abilities, cognitive functions and quality of life, thus it is important to early diagnose and prevent PSD.
Cognitive complaints are associated to multi-morbidity in an old population with good cognitive functioning
Authors: Atti A.R. , Marengoni A. , De Ronchi D. , Palmer K. , Forlani C. , Dalmonte E. , Fratiglioni L.
Published: May 2011

Introduction

The role of cognitive complaints has recently received increasing attention in dementia research.

Aim

To investigate whether the subjective perception of cognitive deficits is related to multi-morbidity in an old Italian cohort.

Methods

The study population(N = 6,825) included persons who did not receive a diagnosis of dementia(DSM-IIIR criteria), were not cognitively impaired and scored < 4 at the Global Deterioration Scale(GDS). On GDS stage one, Individuals with GDS score equal to one do not report memory problems and no deficits are detected during the interview. In subjects with GDS score = 2, a very mild cognitive decline is appreciable. On GDS score = 3,deficiencies begin to be noted. The examining physicians diagnosed the somatic disorders according to the International Classification Disease version 10 (ICD-10). Mental health was clinically assessed by the examining physicians with semi-structured questions. A multimorbidity index was created based on the number of co-occurring chronic disorders. Binary logistic regression analyses were used to estimate multiadjusted Odds ratio (aOR) and 95% Confidence Intervals (CI).

Results

According to GDS, 28.4% (N = 1,940) of participants reported some degree of perceived cognitive decline. Cognitive complaints were associated with increasing age, low education, and multimorbidity. Stroke (aOR,95%CI 1.6;1.3–1.9),diabetes(aOR,95%CI 1.4;1.1–1.7),depressive(aOR,95%CI 2.2;1.8–2.7) and anxiety symptoms(aOR, 95%CI 1.5;1.3–1.8) were significantly associated with perceived cognitive decline. When performances at MMSE were taken into account, cardiovascular(aOR,95%CI 2.3;1.3–4.1) and respiratory diseases(aOR,95%CI 1.9;1.0–3.6) were associated with self-perceived cognitive decline in absence of observable cognitive deficits.

Conclusions

Cognitive complaints have many somatic correlates and some of them may account for the discrepancy between perceived cognitive decline and cognitive assessment.
Clinical audit on nice guidance on anticholinesterases in a memory clinic
Authors: Bangar S. , Powell R.
Published: May 2011

Introduction

The National Institute for Clinical Excellence (NICE) has laid down certain guidelines for prescribing Anti-cholinesterases in patients with dementia. Keeping in mind the NICE guidance, an audit was conducted to see whether these were followed.

Aims and objectives

To ascertain the level of compliance to the NICE guidance and ensure they are adhered to.

Method

The data was collected from patients attending the memory clinic at Park Royal Centre for Mental Health in Central London over a six month period. Sixteen patients were randomly selected for this audit. The baseline MMSE score was recorded and also the medication prescribed.

Results

The baseline MMSE score in all the 16 (100%) patients was above the recommended score of 12.

The MMSE score was done in 12(75%) patients during follow up at 4–6 months.

Of the 12 available MMSE scores at follow up, none were below 12 and hence continued treatment.

In 2 (12.5%) patients there was an improvement, in 6 (37.5%) patients there was a fall and in 4 (25%) patients there was no change in the MMSE score at follow up.

Conclusion

It was found that the NICE guidance was followed in most (75%) patients.
Quality of life and mortality in elderly patients with schizophrenia: a prospective cohort study
Authors: Béra Potelle C. , Cuervo Lombard C.V. , Tran É. , Barrière S. , Schuster J.P. , Limosin F. ,   Investigateurs de l’Étude CSA (Cohorte Schizophrènes Agés)
Published: May 2011

Introduction

The increase of elderly schizophrenia patients during the last few decades is a major health issue. Although life expectancy increased for patients with schizophrenia, there is a greater rate of the occurrence of somatic illnesses, and premature mortality remains 2 to 3 times higher in these patients than in general population.

Objectives

To prospectively assess health care access, quality of life, functional status, and rates and causes of death in a cohort of elderly schizophrenia patients.

Methods

We initiated a national epidemiologic 5-year cohort study including a large sample of schizophrenic patients aged 60 or more. The first aim was to assess the geriatric psychiatric services provided by a large sample (n = 108) of departments of psychiatry in France (n = 829). The second aim was to assess the number of elderly schizophrenia patients followed by each participating centre. Finally, we prospectively assess some demographic, clinical and biological variables, as well as quality of life indexes.

Results

The geriatric psychiatric services are heterogeneously spread in French territory. Schizophrenic patients aged 60 and more represent 15% of French public psychiatric department activity. The cohort is actually in course of constitution.

Conclusions

Our data may help to identify factors associated with increased morbidity and mortality in elderly schizophrenia.
Gender differences in elderly patientswith depression
Authors: Dessoki H. , Moussa F. , Nasr M.
Published: May 2011

Objective

To detect phenomenological gender differences in elderly patients with depression for better understanding. In addition to illustrate neuro- psychological gender differences in elderly patients with depression for better management.

Subjects

A case/control, comparative study with consecutive sample. 80 elderly Egyptian subjects of both sexes aged 60 years or above recruited from psychiatry outpatient clinic in Kasr Al Aini and Beni Suef hospitals with no obvious cognitive impairment or substance related psychiatric disorders. The subjects were classified into 2 groups (depressed patients and control groups) 40 subjects each.

The Methods

Diagnostic criteria of the DSM-IV TR, Symptom checklist, MMSE, GDS,WAIS and STAI were used.

Results

Comparison between the depressed patients and the control group revealed that the depressed group has affected cognitively than the control group as assessed by MMSE and also showed deterioration of intellectual abilities (deterioration index). Comparison between the depressed males and females subgroups revealed that the characteristics of the patients and correlates of depression are similar in both sexes except for some significant findings e.g, depression in elderly women is more associated with widowhood, more suffering of sense of worthlessness, more affection of attention and more disturbance in reasoning and costructional abilities.

Conclusion

Depression in older patients is related to widowhood, presence of family conflicts an positive past history of depression. There were no gender differences in elderly depressed patients except for that depression in elderly women is more associated with widowhood, sense of worthlessness, more affection of attention and more disturbance in reasoning.
Characteristics of elderly patients attended at a psychiatry emergency room
Authors: Prats L. , Gual N. , Lusilla P. , Gual A.
Published: May 2011

Introduction

There is no general agreement on the prevalence of mental disorders in the elderly, although it is estimated that 25%. of them present psychiatric symptoms. Geriatric psychiatry is one of the most rapidly advancing fields and requires a comprehensive approach.

Objectives

To analyse the characteristics of patients older than 65 who are attended at the psychiatry emergency room.

Methods

A descriptive study was conducted among all elderly pacients seen during May 2010 at the psychiatry emergency room at Vall d’Hebron University Hospital. Clinical variables (functional status, reason to show up, medical history, diagnosis), treatment and referral at discharge were analysed.

Results

36 patients (44.4% men, mean age 75.3 years) were identified. Charlson comorbidity index was 2.08. Suicide attempts were the most frequent reason for admission (27.8%), followed by psychomotor agitation (16.7%), anxiety disorders (13.9%), delirium (13.9%), depression (11.1%), and behaviour disorders (8.3%). Concerning psychiatric antecedents 58.3% had depressive disorder and 40% reported somatic symptoms during the month prior to their consultation.

The most common diagnosis at discharge were anxiety-depressive disorders (52.7%) and delirium (16.7%). The most widely prescribed psychotropics were antipsychotics (19.4% haloperidol, 13.9% quetiapine) followed by benzodiazepines (13.9%). Referral at discharge was: 41.7% home, 13.9% midterm psychiatric units, 27.8% acute psychiatric inpatient unit and 16.7% Internal Medicine.

Conclusions

Typically, elderly patients attended at the psychiatric emergency room are diagnosed of an anxiety-depressive disorder and often present with a suicidal attempt, but only 41.7% are admitted as psychiatric inpatients.
Delirium and parkinsonic syndrome in elderly
Authors: Guerra C. , Azevedo J. , Massano J. , Fernandes L.
Published: May 2011

Delirium is an acute or subacute syndrome characterized by a fluctuating global disorder of cognition, impairment of attention and awareness, disorganization of thought and speech, perceptual disturbances, hallucinations, as well as hypo or hyperactivity.

We present a case report of a 76-year-old woman who developed disorientation, lack of familiar recognition and functional impairment, three days before admission. She was admitted to a Medicine Department and submitted to several laboratory and imaging studies.

During this period she presented attention, consciousness fluctuations and agitation that required several treatments, including neuroleptics. Like these symptoms were linked to an important life even that triggered reactive depression, she was transferred to a psychiatric ward. Progressively her clinical state worsened, she became permanently bedridden and was observed by Neurology. She presented moderate to severe parkinsonian signs, namely akinesia and rigidity, predominantly on her left side. Reviewing her clinical past, she had suffered these symptoms during the two years before this episode (apathy, small stepped gait, flexed posture, and left hand rest tremor). Treatment with antiparkinsonic drugs produced a dramatic improvement in the patient’s mental and physical status. A I-Ioflupane-SPECT (DaTscan) confirmed striatal presynaptic dopaminergic degeneration, more on the right side, which was the proof of the presence of a degenerative parkinsonian syndrome.

The present clinical case shows Delirium with degenerative Parkinsonism comorbidity, worsened by the use of neuroleptics. We emphasize the importance previously undiagnosed Parkinsonism in old age which is highlighted by usefulness of dopamine transporter imaging in this scenery.
Depressiveness in preoperative period and postoperative recovery of orthopedic patients - preliminary results of prospective study
Authors: Ignjatovic Ristic D. , Janjic V. , Ristic B. , Radmanovic B.
Published: May 2011

Introduction

Depression is often occurred after surgical interventions and may have serious consequences on postoperative recovery. The treatment of early discovered depressive symptoms may have strong influence on the recovery of operated orthopedic patients.

Simple and quick instrument for detection and evaluation of depressive symptoms could be of great use to doctors.

Work objectives are

1) determine the prevalence of depressiveness in preoperative period in patients with scheduled surgical interventions, and

2) validation of Geriatric Depression Scale - short form (GDS-SF) in detection of depressiveness.

Method

A sample of 120 orthopedic patients is the part of larger sample in prospective research of depressiveness in patients in preoperative period with scheduled surgical interventions (except cardio-surgical). For estimation of depressiveness we used battery of tests (GDS-SF, BDI - Beck's depression scale, MDI - major depressive disorder questionnaire), and patients were tested 3 times: to 14 days prior the surgery, 7 and 90 days after the surgery. Validation of GDS-SF was examined compared to BDI according to age and gender of examinees.

Results

In preliminary sample of 120 orthopedic patients with scheduled orthopedic interventions, prevalence of depressiveness is greater than prevalence of depressiveness in general population (p < 0.001). Depressiveness is much more present in women than in men (p < 0.001). Correlation of depressive scores in BDI and in GDS-SF is satisfactory for all age groups.

Conclusion

Preliminary results indicate on further research of depressiveness in preoperative period in order to confirm validation of GDS-SF as simpler alternative for early detection of depressiveness.
Mental health of older people: the role of primary care
Authors: Ivbijaro G. , Torres-González F. , Parmentier H. , Gómez-Beneyto M.
Published: May 2011

There are currently over 600 million people aged over 60 and it is predicted that, by 2025, the number will double and, by 2050 there will be over 2 billion people aged 60 and above and the number of over 60's will be greater than the number of children under the age of 15. Co-morbid physical and mental health conditions are associated with an aging population and many of this population will suffer from stroke, hypertension, loneliness, depression, dementia, mobility and sight problems. The traditional approach of caring for people in hospitals is increasingly inappropriate for many of the elderly population and primary care is often the first point of contact for many people seeking access to health and social care. In 2008, the WHO and Wonca (World Organisation of Family Doctors) published a document about the integration of mental health into primary care across spectrum. We will be describing the principles and method of integration of mental health problems in old age into primary care using examples from the Australian and UK setting. Also we will examine the role non-governmental organisations can play in the process of integration. Caring for the elderly is rewarding and possible in the primary care setting. The current situation where many elderly people do not have access to an integrated health care system is unacceptable. Using data and a series of case vignettes we will illustrate that primary care has an important role to play within an integrated system.
P02-243 Life satisfaction, depression and spirituality for Korean elderly people
Authors: Lee S.B.
Published: May 2011

Aim

The purpose of this study was to assess Korean elderly people's residential condition with or without cohabitants, spouse and children, and to analyze their depression, spirituality and life satisfaction depending on residential condition.

Methods

160 subjects were randomly selected from one of religious organizations, Suwon City, Kyounggi Do, South Korea. The participants were divided into Group 1 (the elderly living alone: n = 74, Mean Age = 72.45, SD = 6.78) and Group 2 (the elderly living with spouse and/or children: n = 86, Mean Age = 72.12, SD = 6.82). The subjects participated in the survey forms of spiritual well-being, life satisfaction, and depression. It was hypothesized that the elderly living alone (Group 1) had lower scale in the areas of spiritual well-being, life satisfaction and higher scale in depression.

Results

The t-test on the mean of each scale for the Group 1 and Group 2 was significant: Korean elderly people, who were living alone without family support, were less satisfied (p < .001), more depressed (p < .0001) and their spiritual well-being scale was lower (p < .001). For the total participants (n = 160). there was a positive correlation between spiritual well-being and life satisfaction (rho = .56, p < .001). There was negative correlation between depression and spiritual wellbeing (rho = −.67, p < .0001); depression and life satisfaction (rho = −.78, p < .0001).

Conclusion

For the mental health professionals, including psychiatrists and gerontologists, it is important to understand the elderly people's residential situation, emotional support as well as to assess their life satisfaction and spiritual well-being in terms of quality of life measurement.
Elder abuse in Poland
Authors: Leszek J.
Published: May 2011

Poland is a country with a rate of demographic aging similar to other developed nations. The percentage of pesons 60 yrs and older is expected to rise dramatically to 20% by 2020.

The complexity of elderly’s life situations in Poland increases the probability that they will be subject to neglect and abuse.It is difficult to estimate the extent of this problem in Poland.

Polish gerontological literature has not defined abuse and neglect with regard to the elderly people. In this situation is difficult to estimate the extent of this problem in Poland. Individual studies only marginally suggest the existence of this phenomenon. According to this investigations, the following factors take part in elderly abuse:

* the increased rate of aging of the ruled society (16,5%) compared to urban society(12,8%)- a result of intensive migration process

* the influence of the residence on the creation, course on results of family conflicts

* in cities neglect and abuse of the elderly are more frequently (a results of a shortage of flats, lack of specified social roles for old age, their dependency in terms of care and help, and alcohol abuse)

difficult economic situation for retired people

The kind of elder abuse:

1.

psychological aggression occured more often than physical aggression

2.

emotional neglect

3.

economic neglect

4.

isolations from family

5.

neglecting the care of older people

6.

material abuse

Knowledge about the problems of elder abuse in Poland as not satisfactory till now is currently under discussion and new concept of this phenomenon will be prepared.
Comorbidity of Current Depression Among the Elderly
Authors: Manetti A. , Hoertel N. , Le Strat Y. , Schuster J.-P. , Limosin F.
Published: May 2011

Introduction

Depression in later life is a major public heath issue. Few studies to date examined the psychiatric correlates of depression in elderly surveys in the general population.

Objective

To provide nationally representative data on the prevalence, sociodemographic correlates and comorbidity of current major depressive disorder in late life.

Methods

This study is based on a nationally representative survey, the National Epidemiologic Survey on Alcohol and Related Conditions, of the noninstitutionalized household population (8,205 respondents aged 65 and above). The past 12-months prevalence of major depressive disorder was estimated, and logistic regression analyses were used to examine the relationship between 12-months major depressive disorder and sociodemographic characteristics, general medical condition and psychiatric disorder. Diagnoses were made according to the of DSM-IV criteria.

Results

Among the respondents, 3.2% individuals with a past 12-months diagnosis of major depressive disorder were identified. Women and individuals living in urban areas were more likely to be diagnosed with a major depressive disorder. Significant associations between major depressive disorder and cardiovascular, gastrointestinal diseases, arthritis were found. Several psychiatric disorder were associated with past 12-months major depressive disorder, including dysthymia, bipolar disorder, panic disorder, specific phobia, generalized anxiety disorder, nicotine and alcohol dependence, and histrionic personality disorder.

Conclusion

Recent Major depressive disorder in the elderly was associated with a large number of psychiatric disorders. This study highlights the need to develop effective and targeted intervention initiatives to detect major depressive disorder in elderly.
Evaluating the emotional distress of elderly individuals with COPD and with chronic pain, according to the Ama Guides Fifth Edition
Authors: Miciano A.
Published: May 2011

There has been no previous systematic research on the pain-related impairment (PRI) system of the AMA Guides. The objective was to examine the emotional distress (ED) status of COPD patients with chronic pain using responses from the Ratings Determining Impairment Associated With Pain (RDIP), a formal assessment for rating PRI by the AMA Guides to Evaluation of Permanent Impairment, Fifth Edition. The PHQ-9 identified 30 of 100 elderly outpatient COPD subjects afflicted with ED. The RDIP and Physical Performance Tests scores (PPT: 6-Minute Walk, Berg Balance, & Dynamic Gait Index), were recorded. The RDIP consisted of 5 items (Pain Severity, Activity Interference , Emotional Distress, Pain Behavior, & Credibility subscales) scored for a maximum 80 and was subcategorized: 69% mild, 25% moderate, 3% moderately-severe and 3% severe PRI. The ED scores ranged 1.6 to 9/10 with an average 7.2/10. Comparing the effect of ED over AI component revealed that 12.5% of the total RDIP score (range 2–11%) was due to ED. The RDIP rating demonstrated a close trend relationship between the PRI scores and low PPT scores. The majority scored in the mild PRI, which still had a high trend effect on ED. Pain effect on mood had also a close trend with the little variation in PPT. These findings suggest that the pain disability status of COPD patients, regardless of severity, results in significant increase in their ED. Further research on the AI & ED and their correlations to decreased physical performance would be beneficial.
Discharge destination of patients from a psychogeriatric unit
Authors: Ochuko-Emore M.
Published: May 2011

Objectives

To determine the discharge destination of patients admitted to a psychogeriatric unit.

Methods

Records of all patients discharged from an in-patient psychogeriatric unit between 1st July 2009 and 30th June 2010 were examined. The diagnosis, residence at admission, length of stay and discharge destination were recorded.

Results

There were ninety-four discharges over the study period. Four of the patients were admitted and discharged twice. The mean age was 76.7 years (range 65–95 years). 52.1% (n = 49) were diagnosed with dementia and 47.9% (n = 45) with functional mental illness. The average length of stay was 67.4 days for dementia compare to 74.2 days for functional mental illness. 17.1% (n = 6/32) of patients with dementia and 84.2% (n = 32/38) of patients with functional mental illness resident at home at the time of admission were discharged home.

Conclusion

This finding suggests that patients with functional mental illness are more likely to be discharge back to their homes compared with patients with dementia.
Dementia in Parkinson's disease: Case report
Authors: Oliveira S.G. , Pereira S.M. , Mendes J.
Published: May 2011

Introduction

Parkinson's disease (PD) dementia is a rapidly growing global health problem. Dementia in PD is often accompanied with neuropsychiatric manifestations, such as depression, insomnia, visual hallucinations and psychomotor agitation, which need psychiatric attention.

Objectives

The authors’ aim is to report a case of a 76-year-old female suffering from PD who was admitted to the psychiatric yard exhibiting neuropsychiatric symptoms. A literature's review about PD dementia was also made.

Case report

Patient had one psychiatric hospitalization at age 41, due to depressive symptoms. PD diagnose was made at age 65 and initially responded well to levodopa. Over the subsequent years, motor fluctuations and dyskinesias as well as autonomic, cognitive and psychological symptoms gradually developed. At 75 years, patient's family stated that she had been more forgetful, impulsive, showing signs of anxiety and dysphoria. She was hospitalized exhibiting psychomotor agitation, disorientation, insomnia and mainly nocturnal visual hallucinations with persons. Diagnostic testing included: cranial tomography which showed mild generalized atrophy but no other structural cause of her symptoms; laboratory tests with B12, folic acid, thyroid function; syphilis detection test and examinations of serum and urine were normal. The MMSE scored 19. Attention deficits and constructional apraxia were present in clock drawing test. Treatment was initiated with memantine and a low dose of quetiapine. She was discharged after 20 days with improvement of neuropsychiatric symptoms.

Conclusions

Early diagnosis and treatment of dementia in PD may prevent psychiatric hospitalization and avoid patient's and family's distress.
Assessment and support for carers of dementia patients at sandwell park hospital, hartlepool, UK
Authors: Reddy J.
Published: May 2011

Introduction

NICE Guidelines on Dementia (CG42) recommends that the Carers assessments should seek to identify any psychological distress and the psychosocial impact on the carer, including after the person with dementia has entered residential care. The assessment is offered by Health and social care managers.

The assessment includes

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Individual or Group Psycho education

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Peer support groups, tailored to the needs of the individual (for example, the stage of dementia of the person being cared for)

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Telephone support and internet information

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Training courses about dementia, services and benefits.

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Psychological therapies like CBT

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Practical support like transport, day care and Respite/short-break care

Objective

To identify the support received by the carers of patients suffering from Dementia.

Method

A standardised questionnaire was answered by 25 carers attending the Outpatient clinics, Memory clinics, Day Hospital & Inpatients at Sandwell park Hospital, Hartlepool. The questionnaire contained 8 questions reflecting NICE guidelines. The audit was carried out between Nov 2008 and Jan 2009.

Results

The standard was met up to 80% (20).

Everybody was aware of all the available support except five carers.

Three were not aware of the Psychological therapies and two were not aware of Training courses about Dementia.

Conclusions

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Dissemination of the report through Trust email to the Health and social care managers involved in the care of the carers in the catchment area.

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Educational meetings for the carers to be arranged

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Conduct the Audit in a year's time.
Hippocampal cavities in elderly subjects - prevalence, evolution and impact on cognition
Authors: Riese F. , Ballach O. , Suliman H. , Geertz H.-J. , Wolf H.
Published: May 2011

Hippocampal cavities (HcC) are frequent findings in brain MRIs of elderly subjects. The prevalence, evolution and impact on cognitive performance of these cavities are unclear. Our study therefore aims at providing data on prevalence, morphological evolution and clinical significance of HcC. We used a population-based sample of nondemented elderly subjects aged 75–85 and a comparison group with Alzheimer's disease for cross-sectional analysis. All nondemented subjects were included in a prospective study (mean follow-up 3.2 years). HcC numbers and volume were recorded from volumetric T1w MRI scans. Serial MRIs were performed for a subgroup of subjects. Cognitive functions were assessed by SIDAM and CDR. Hippocampal and brain volume, medial temporal lobe atrophy, white matter lesions, ApoE genotype and vascular risk factors were considered as confounders. The prevalence of HcC in our sample was approx. 60% with no differences between cognitive groups. HcC volume was found to be a predictor of short-term episodic memory performance. The effect of HcC volume was non-linear with the highest risk for decrease in short-term memory associated with the smallest HcC volumes. Mean HcC number and volume remained stable during follow-up. However, we provide anectodal evidence for both cases with increase and decrease of HcC volume over time. In conclusion, small HcC may be an independent risk factor for decline in short term episodic memory performance in elderly subjects.
Towards an improvement of medical and psychological care in a nursing home
Authors: Rojo Á. , Fernandez E.
Published: May 2011

Introduction

Valle Inclán Nursing Home is a multifunctional centre of Gerontology, that offers social and health services to elderly people, either with physical independence or with physical and psychic disabilities. Mental illness is studied from a multidisciplinary point of view, and these different therapeutic programs are implemented: psychological support for adjustment disorders, cognitive-behavioural therapy for mood disorders and overall medical examination of dementia. The total sample of patients that are studied is 445, chronologically distributed according the next data: N: 234 (2006), N: 264 (2007), N: 258 (2008) y N: 243 (2009).

Objectives

To know the prevalence of the main psychiatric pathologies and to compare to data found in scientific literature.

To find data that can be used in order to improve the quality of medical care and psychosocial attention.

Method

The prevalence of different psychiatric conditions treated by this mental health department, and the variation of these data for the last four years are showed. These data are compared with those in scientific literature.

Results

Mental illness prevalence distribution is similar to the prevalence that is found in scientific literature. Dementia is the most prevalent pathology, and mood disorders are in the second place.

Conclusions

The decrease in the prevalence of mood disorders is probably on account of the implementation of specific psychotherapeutic programs. An increase in the prevalence of dementia can be explained by the improvement of screening of this illness and/or the increasing social request for admission to these nursing homes.
The elderly over 90yr affected by deperession post-stroke respond well to antidepressant therapy with SSRI? study on a population admitted in nursing home (RSA)
Authors: Santangelo A. , Testai M. , Albani S. , Cappello A. , Castelli R. , Pavano S. , Tomarchio M. , Maugeri D.
Published: May 2011

Introduction

The frailty of elderly in Tenth Decade with stroke was considered a certainty for many years ruling, and the stroke in 90 year old was a paradigm of fragility in gerontology. However soon enough the existing data on the population in nursing homes.

Method

The aim of this study was to evaluate the response to therapy SSRI antidepressants (fluoxetine 20–40 mg; sertraline 25–100 mg,; citalopram 10–40 mg) in a population of olds with depression after-stroke hospitalized in Nursing Home (RSA) at Catania (Sicily). We evaluated a total sample of 66 patients comparing the 13 patients 90yr-old with the 53 patients younger pertaining to the same RSA for stroke.

Results

Stackable with somatic comorbidity and the post-stroke depression between the two populations, we founded:

1.

Both populations are responsive to antidepressant treatment with SSRIs

2.

The ninety recover more and more 'rapid cognitive impairment

3.

Both Populations improves the performances with rehabilitation recovering functional self-autonomy, albeit from different levels.

4.

The nutrient levels overlap in both populations and increased fragility biological of over 90-year old is evident for among of Prevalence and incidence of Delirium and Presence of Pressure Sores.

Conclusion

According to this data the response to antidepressants seems to be good and totally overlapped with the population most 'young studied as a reference.

This data also confirms that it is not age itself but the comorbidity of diseases present that make it’ a frail old man and that probably the frailty of the nineties is a biological myth.
Prevalence of mental disorders in late life
Authors: Semke V.Y.
Published: May 2011

In late life patients considerably more seldom than patients of other age groups reach attention of psychiatrists due to obliteration of symptoms of mental suffering, their masked by somatic symptoms manifestation, not seldom - negative attitude of relatives toward psychiatric assistance etc.

Study of patients of elder and older age at units of somatic hospital of another profile (therapeutic, cardiologic, neurological, traumatologic) has shown that mental disturbances are revealed in 74,4 % of them. Non-psychotic forms of disorders are basic (73,8 %), more seldom psychoses are found (18,6 %) and dementias of various nature (7,6 %). Of most prevalence in this contingent were disorders related with cerebral-vascular diseases (42,6 %), including those with acute disturbances of brain blood circulation (20,5 %). Somatogenic mental disorders occupy more modest place counting 8,8%. Neuroses including nosogenias are observed in 9,2 % of cases. Endogenous diseases are rarely found in patients of a somatic institution (6,7 %).

In recent years significant growth of organic mental disorders in Russian Federation occurs predominantly at the expense of the elderly. In structure of this pathology as selective epidemiological investigations show the first place according to incidence rate is occupied by cerebral-vascular diseases (34,1 %); the second place is occupied by neurotic disturbances (26,0 %); the third one - affective disorders (15,4 %).

Differences in sickness rate and morbidity in such conditions identified by researchers in different populations may reflect more particularly their diagnostic approaches than the true differences in incidence and prevalence.