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Undiagnosed depression and cognitive impairment with possible dementia among elderly population in urban areas of Hyderabad: Prevalence and associated factors 海得拉巴城市地区老年人群中未确诊的抑郁症和认知障碍伴痴呆症的患病率及相关因素
Pub Date : 2022-07-01 DOI: 10.4103/jgmh.jgmh_46_22
Saba Syed, Pranati Kilaru
Background: Elderly population in India is steadily increasing and depression and dementia are the most common neuropsychiatric disorders in the older adult population. Epidemiological studies have reported disparity in the prevalence of mental health morbidity in older Indian adults. The aim of the present study was to assess community-based prevalence of undiagnosed depression and cognitive impairment with possible dementia and its associated factors in elderly persons residing in urban areas. Materials and Methods: The present study was a cross-sectional community-based study conducted in persons above 60 years residing in urban localities of selected four different zones of Greater Hyderabad through multistage sampling. The questionnaire consisted of sociodemographic details, the validated “Mini-Mental State Examination (MMSE)” Questionnaire and Geriatric Depression Scale short-form. Results: The study was completed with a total of 230 individuals. The mean age of participants was 68.02 (±5.71) years. The study group comprised 50.87% males and 49.13% females and 56.08% of participants were self-employed/employed. Of total participants, 37.39% were residing alone of whom 70% were male. More than half (57.83%) of study participants had studied less than 8th grade. Cognitive impairment with possible dementia was present in 51.74% of participants, the prevalence of depression was 22.71% and in 16.09% of participants, both conditions coexisted. Factors found to be significantly associated with depression and cognitive impairment with possible dementia or both conditions were current unemployment [Odds ratio [OR] 5.0 (95% CI (2.44–10.81)], residing alone (OR 2.78 [1.48–5.23]) and education less than high school (OR 24.85 [2.53–9.32]). Conclusions: Depression and cognitive impairment with possible dementia were considerably prevalent in the elderly population of Hyderabad, India. Factors significantly associated with the prevalence of either or both conditions were, residing alone and education less than high school.
背景:印度老年人口正在稳步增加,抑郁症和痴呆是老年人群中最常见的神经精神疾病。流行病学研究报告了印度老年人心理健康发病率的差异。本研究的目的是评估居住在城市地区的老年人中未确诊的抑郁症和认知障碍伴可能痴呆的社区患病率及其相关因素。材料和方法:本研究是一项横断面社区研究,通过多阶段抽样,对居住在大海得拉巴四个不同区域的城市地区的60岁以上人群进行了研究。问卷包括社会人口学资料、经验证的“简易精神状态检查”问卷和老年抑郁量表简表。结果:共230人完成了研究。参与者平均年龄为68.02(±5.71)岁。研究对象中男性占50.87%,女性占49.13%,自雇/受雇者占56.08%。在所有参与者中,37.39%独居,其中70%为男性。超过一半(57.83%)的研究参与者学习不到8年级。51.74%的参与者存在认知障碍和可能的痴呆,22.71%的参与者存在抑郁症,16.09%的参与者存在这两种情况。发现与抑郁和认知障碍以及可能的痴呆或两种情况显著相关的因素是当前失业[比值比[or] 5.0 (95% CI(2.44-10.81)]、独居(or 2.78[1.48-5.23])和教育程度低于高中(or 24.85[2.53-9.32])。结论:在印度海德拉巴的老年人群中,抑郁症和认知障碍伴可能的痴呆相当普遍。与其中一种或两种情况的患病率显著相关的因素是独居和受教育程度低于高中。
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引用次数: 0
Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South India 中风幸存者的残疾、照顾者负担和应对抑郁之间的关系:一项在南印度的横断面研究
Pub Date : 2022-07-01 DOI: 10.4103/jgmh.jgmh_47_22
Saraswathi Nagaraju, A. Saroja, K. Naik, V. Harbishettar
Background: Post-stroke depression (PSD) is seen in up to 35% of stroke survivors, contributing to morbidity and caregiver burden, that could deter the acute and rehabilitation treatment. Depression in stroke contributes to more disability and caregiver burden. Understanding coping methods of caregivers in PSD results in better caregiving, reduces stress and improves family relationships. There is paucity of studies examining PSD and its determinants in Indian context. Objectives: The objective is to study the association of PSD with disability, with caregiver burden, and coping methods adopted by the caregivers. Methods: Consenting participants (and their caregivers) attending Neurology outpatients with the first episode of Stroke (N=226) in a tertiary care center in a tier 2 city in South India, with 56% participants from rural background, were evaluated between three and six months of stroke. Two groups namely PSD (n = 67) and post-stroke without depression (PSwD, n = 159) based on cutoff score of 9/10 on a valid Hamilton Depression Rating Scale were compared for their demographics, social, physical, and functional factors. Barthel Disability Index (BDI) for disability, Zarit Burden Interview (ZBI) for caregiver burden and coping checklist (CCL) by Rao et al. on caregivers particularly prepared for studying in the Indian context were also administered. Results: The rate of PSD was found to be 29.6%. PSD group were older and had relatively more common in females (p < 0.001). The type of stroke and site of vascular lesion were not associated with PSD (p = 0.68 and p = 0.24). Stroke severity scores were higher in PSD group (p < 0.001). Disability as per BDI scores was greater in PSD group against PSwD group (p < 0.001). ZBI scores show greater caregiver burden in PSD group than PSwD (p < 0.001). Measures were significantly higher in all CCL sub-categories in caregivers of PSD group compared with PSwD. Conclusion: PSD prevalence of close to one third in stroke survivors, with female gender, older age, stroke severity, and functional disability as its key determinants. Furthermore, the PSD was significantly associated with caregiver burden and study also found preferred coping methods were adopted by caregivers of PSD group. Early identification and treatment of PSD is of utmost important to minimize disability, reduce caregiver burden and improvise coping methods.
背景:高达35%的中风幸存者出现中风后抑郁(PSD),导致发病率和护理人员负担,这可能会阻碍急性和康复治疗。中风时的抑郁会导致更多的残疾和照顾者的负担。了解PSD中照顾者的应对方法可以获得更好的照顾,减轻压力,改善家庭关系。在印度背景下,很少研究PSD及其决定因素。目的:研究PSD与残疾、照顾者负担以及照顾者采取的应对方法的关系。方法:在南印度一个二级城市的三级护理中心,对首次中风(N=226)的神经科门诊患者(56%的参与者来自农村背景)的同意参与者(及其护理人员)在中风三到六个月之间进行评估。两组,即PSD(n=67)和卒中后无抑郁(PSwD,n=159),基于有效汉密尔顿抑郁量表的9/10分,比较了他们的人口统计学、社会、身体和功能因素。针对残疾的Barthel残疾指数(BDI)、针对照顾者负担的Zarit负担访谈(ZBI)和Rao等人的应对清单(CCL)。还对特别准备在印度学习的照顾者进行了管理。结果:PSD的发生率为29.6%。PSD组年龄较大,在女性中相对更常见(p<0.001)。卒中类型和血管病变部位与PSD无关(p=0.68和p=0.24)。PSD组的卒中严重程度评分较高(p<001)。根据BDI评分,PSD组的残疾程度高于PSwD组(p<0.01)。ZBI评分显示PSD组的照顾者负担高于PSwD(p<0.001)。与PSwD相比,PSD组照顾者的所有CCL亚类的测量值显著更高。结论:PSD在脑卒中幸存者中的患病率接近三分之一,女性、年龄较大、脑卒中严重程度和功能残疾是其关键决定因素。此外,PSD与照顾者负担显著相关,研究还发现PSD组的照顾者采用了首选的应对方法。PSD的早期识别和治疗对于最大限度地减少残疾、减轻护理人员负担和即兴应对方法至关重要。
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引用次数: 0
Exergaming as a mental health intervention in the elderly: A clinical review 运动作为老年人心理健康干预的临床回顾
Pub Date : 2022-07-01 DOI: 10.4103/jgmh.jgmh_16_22
I. Bhattacharya, Divya Ambetkar, Vishakha S. Patil, A. De Sousa, S. Karia
Exergames is a new arena of mental health intervention in the elderly. The present article is a clinical review on various areas where exergaming has been used to enhance mental health in the elderly. The review looks at the use of exergames in dementia, geriatric depression, as a tool for movement and to improve memory and cognition. The role of exergames in improving intellectual function, instability and falls in the elderly is also discussed. The role of exergames to improve fragility is mentioned. The review looks at the advantages and disadvantages of exergames in the elderly and the limitations of various studies done so far from a clinical and scientific rigor standpoint. The future research needs are also discussed. Exergames is a mental health intervention area in geriatric mental health that will be used more in the years to come.
运动会是老年人心理健康干预的一个新领域。本文对运动游戏被用于增强老年人心理健康的各个领域进行了临床综述。这篇综述着眼于运动游戏在痴呆症、老年抑郁症中的应用,将其作为运动、改善记忆和认知的工具。还讨论了运动游戏在改善老年人智力功能、不稳定和跌倒方面的作用。提到了运动会在改善脆弱性方面的作用。这篇综述从临床和科学严谨的角度审视了老年人运动游戏的优点和缺点,以及迄今为止所做的各种研究的局限性。并对未来的研究需求进行了讨论。运动会是老年人心理健康的一个心理健康干预领域,在未来几年将得到更多的使用。
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引用次数: 0
A study of handwriting sample in geriatric population with cognitive impairment: A cross-sectional observational study 老年认知障碍人群笔迹样本研究:横断面观察研究
Pub Date : 2022-07-01 DOI: 10.4103/jgmh.jgmh_39_22
V. Heijebu, Bhupendra Singh, S. Srivastava, S. Singh
Objectives: Cognitive impairment in the geriatric population often remains undiagnosed until progressed enough to cause interruptions in activities of daily living. Routine tests are time taking, requiring a specialist. Handwriting function reflects the brain's cognitive capacity by involving it's both halves. It is easy to collect and does not strain the participant, and can aid in the faster diagnosis of cognitive impairment. Materials and Methods: To study handwriting parameters collected with Livescribe Echo Smart Pen and compare them with cognitive scores of Montreal Cognitive Assessment-Hindi (MOCA-H) and Addenbrooke's Cognitive Examination-Hindi (ACE-H) in a cross-sectional observational study. Handwritten parameters differentiating both cognitive groups were identified and analyzed. Results: The mean age of the study population was 66.4 (5.3) years. The mean MOCA score in the cognitively impaired (CI) and noncognitively (NCI) group was 22.67 and 27.00, respectively. The mean ACE-H score in CI and NCI group was 80.68 and 93.05, respectively. In all handwriting tasks (T1-T3), higher scores were obtained on all parameters in the CI group except text width (TW), stroke frequency (SF), and writing speed (WS). In handwriting task 3 (single letter repetition), WC (word count) was found to be higher in the NCI group. Handwriting parameters of the whole task (TOT, PSPS, TW, TH, NOL, and WS) and text line (MTOL and MTOSS) were found to be helpful in group differentiation in all three tasks. There was a moderate degree of positive correlation with handwriting parameters (PSPS, WS, and WC) and a negative correlation with handwriting parameters (NOPS, TOT, TH, NOL, MHOL, MTOL, and MTOSS) across the tasks with MOCA and ACE scores. Conclusion: Inclusion of quantitative handwriting analysis in neuropsychological assessment can be one step forward towards a simple, reliable, and faster diagnosis of geriatric cognitive impairment.
目的:老年人群的认知障碍通常在进展到足以导致日常生活活动中断时才被诊断出来。常规检查耗时,需要专家检查。书写功能通过涉及大脑的两个半球来反映大脑的认知能力。它很容易收集,不会使参与者紧张,并且可以帮助更快地诊断认知障碍。材料与方法:采用横断面观察法对Livescribe Echo智能笔采集的笔迹参数进行研究,并与蒙特利尔认知评估-印地语(MOCA-H)和阿登布鲁克认知测试-印地语(ACE-H)的认知得分进行比较。识别并分析了区分两种认知组的手写参数。结果:研究人群的平均年龄为66.4(5.3)岁。认知障碍组(CI)和非认知障碍组(NCI) MOCA平均评分分别为22.67分和27.00分。CI组和NCI组ACE-H平均评分分别为80.68分和93.05分。在所有书写任务(T1-T3)中,CI组除文字宽度(TW)、笔画频率(SF)和书写速度(WS)外,其他参数得分均较高。在书写任务3(单字母重复)中,NCI组的WC(单词计数)更高。整个任务(TOT、PSPS、TW、TH、NOL和WS)和文本行(MTOL和MTOSS)的书写参数对三个任务的群体分化都有帮助。与书写参数(PSPS、WS、WC)呈中等程度正相关,与书写参数(NOPS、TOT、TH、NOL、MHOL、MTOL、MTOSS)呈负相关。结论:将定量笔迹分析纳入神经心理学评估,可为老年认知障碍的简单、可靠、快速诊断迈出一步。
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引用次数: 0
Assessment of alexithymia and cognition in elderly patients with depression: A cross-sectional exploratory study 老年抑郁症患者述情障碍和认知能力评估的横断面探索性研究
Pub Date : 2022-07-01 DOI: 10.4103/jgmh.jgmh_41_22
A. Faye, R. Tadke, S. Gawande, S. Bhave, V. Kirpekar, Ayan Chatterjee
Objectives: Depression is the most common psychiatric illness in the elderly. Alexithymia and cognitive impairment can be independently associated with depression and old age. This study aims to assess the alexithymia and cognitive dysfunction in geriatric patients with depression. Materials and Methods: A cross-sectional study was conducted on 100 participants of >60 years with depression. Participants were assessed using semi-structured pro forma, Geriatric Depression Scale (GDS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20) having 3 subscales – “difficulty describing feeling” (DDF), “difficulty identifying feeling” (DIF), and “externally oriented thinking,” and Montreal Cognitive Assessment (MoCA). Statistical analysis was done using Chi-square/Fisher's exact test, Pearson's correlation, and t-test. Results: The mean age of the participants was 67.35 years with equal gender distribution. Thirty-four percent were >70 years of age and 53% from rural area. The median duration of depression was 30 months with a median duration of untreated illness, 6 months. Anxiety was the most common psychiatric comorbidity (43%). Seventy-one percent had alexithymia whereas 77% had cognitive impairment (MoCA score <26). Scores on GDS, HDRS, TAS-20, DIF, DDF, and MoCA (<26) were significantly higher in elder participants (P < 0.05) and those from rural area (P < 0.05). Higher TAS-20 score correlated with lower MoCA score (P < 0.01). Furthermore, severe depression correlated with higher TAS-20 and lower MoCA score. Conclusion: More than two-third of participants had alexithymia and cognitive dysfunction. Higher alexithymia was associated with poor cognition. Severe depression correlated with higher alexithymia and cognitive impairment. Alexithymia and cognitive dysfunction were higher in the elderly from rural region.
目的:抑郁症是老年人最常见的精神疾病。述情障碍和认知障碍可能与抑郁症和老年独立相关。本研究旨在评估老年抑郁症患者的述情障碍和认知功能障碍。材料和方法:对100名60岁以上抑郁症患者进行了横断面研究。参与者使用半结构化形式、老年抑郁量表(GDS)、汉密尔顿抑郁评定量表(HDRS)、多伦多述情障碍量表-20(TAS-20)进行评估,该量表有3个分量表——“描述感觉的困难”(DDF)、“识别感觉的困难(DIF)和“外向思维”,以及蒙特利尔认知评估(MoCA)。使用卡方/费雪精确检验、皮尔逊相关和t检验进行统计分析。结果:参与者的平均年龄为67.35岁,性别分布均匀。34%的人年龄在70岁以上,53%的人来自农村地区。抑郁症的中位持续时间为30个月,未经治疗的疾病的中位时间为6个月。焦虑是最常见的精神共病(43%)。71%的患者有述情障碍,77%的患者有认知障碍(MoCA评分<26)。老年参与者的GDS、HDRS、TAS-20、DIF、DDF和MoCA得分(<26)显著高于农村参与者(P<0.05)。TAS-20得分越高,MoCA得分越低(P<0.01)。此外,严重抑郁症与TAS-20和MoCA评分越高相关。结论:超过三分之二的参与者有述情障碍和认知功能障碍。述情障碍程度越高,认知能力越差。重度抑郁症与较高的述情障碍和认知障碍相关。农村地区老年人述情障碍和认知功能障碍发生率较高。
{"title":"Assessment of alexithymia and cognition in elderly patients with depression: A cross-sectional exploratory study","authors":"A. Faye, R. Tadke, S. Gawande, S. Bhave, V. Kirpekar, Ayan Chatterjee","doi":"10.4103/jgmh.jgmh_41_22","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_41_22","url":null,"abstract":"Objectives: Depression is the most common psychiatric illness in the elderly. Alexithymia and cognitive impairment can be independently associated with depression and old age. This study aims to assess the alexithymia and cognitive dysfunction in geriatric patients with depression. Materials and Methods: A cross-sectional study was conducted on 100 participants of >60 years with depression. Participants were assessed using semi-structured pro forma, Geriatric Depression Scale (GDS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20) having 3 subscales – “difficulty describing feeling” (DDF), “difficulty identifying feeling” (DIF), and “externally oriented thinking,” and Montreal Cognitive Assessment (MoCA). Statistical analysis was done using Chi-square/Fisher's exact test, Pearson's correlation, and t-test. Results: The mean age of the participants was 67.35 years with equal gender distribution. Thirty-four percent were >70 years of age and 53% from rural area. The median duration of depression was 30 months with a median duration of untreated illness, 6 months. Anxiety was the most common psychiatric comorbidity (43%). Seventy-one percent had alexithymia whereas 77% had cognitive impairment (MoCA score <26). Scores on GDS, HDRS, TAS-20, DIF, DDF, and MoCA (<26) were significantly higher in elder participants (P < 0.05) and those from rural area (P < 0.05). Higher TAS-20 score correlated with lower MoCA score (P < 0.01). Furthermore, severe depression correlated with higher TAS-20 and lower MoCA score. Conclusion: More than two-third of participants had alexithymia and cognitive dysfunction. Higher alexithymia was associated with poor cognition. Severe depression correlated with higher alexithymia and cognitive impairment. Alexithymia and cognitive dysfunction were higher in the elderly from rural region.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"9 1","pages":"100 - 108"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46804656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Delirium in elderly: Battling a silent killer in the Indian context 老年人谵妄:与印度背景下的沉默杀手作斗争
Pub Date : 2022-07-01 DOI: 10.4103/jgmh.jgmh_3_23
S. Grover
Delirium is considered a manifestation of acute brain failure that usually has an acute onset, fluctuating course, and is often associated with multitude of negative outcomes. It is usually seen in medical-surgical patients, with very high prevalence rates among those on mechanical ventilation. It is often undiagnosed and undertreated. In developed countries, delirium is usually managed by multidisciplinary teams and the focus is on both prevention and management of delirium. In contrast to the developed countries, in India, physicians–surgeons have a negative attitude toward delirium and due to which not only it is underdiagnosed and undertreated but also mismanaged, and mental health professionals are not consulted. The research on delirium in India is also limited. The psychiatrists when involved in the care of patients with delirium also mainly focus on using pharmacological agents, with relatively lesser emphasis on the use of nonpharmacological measures. Further, in their encounter with specialists from other specialties, psychiatrists pay little attention to discussing the diagnosis of delirium and its management. There is a need to have an attitudinal change both at the level of the physicians–surgeons and psychiatrists in terms of clinical practice and research on delirium in the Indian context.
谵妄被认为是急性脑功能衰竭的一种表现,通常具有急性发作、波动的过程,并且通常与多种负面结果有关。它通常见于内科手术患者,在接受机械通气的患者中患病率非常高。它通常未被诊断和治疗不足。在发达国家,谵妄通常由多学科团队管理,重点是谵妄的预防和管理。与发达国家相比,在印度,医生和外科医生对谵妄持消极态度,因此不仅诊断不足、治疗不足,而且管理不当,而且没有咨询心理健康专业人员。印度对谵妄的研究也很有限。精神科医生在参与谵妄患者的护理时,也主要关注药物的使用,而相对较少强调非药物措施的使用。此外,在与其他专业的专家会面时,精神科医生很少注意讨论谵妄的诊断及其管理。在印度背景下,医生——外科医生和精神病学家——在临床实践和谵妄研究方面都需要改变态度。
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引用次数: 0
The pharmacological treatment of behavioral alterations in the course of dementia 痴呆过程中行为改变的药物治疗
Pub Date : 2022-01-01 DOI: 10.4103/jgmh.jgmh_18_22
Davi Cristina
{"title":"The pharmacological treatment of behavioral alterations in the course of dementia","authors":"Davi Cristina","doi":"10.4103/jgmh.jgmh_18_22","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_18_22","url":null,"abstract":"","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"9 1","pages":"60 - 62"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44145504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Catatonia in the elderly: Does it require attention! 老年人的紧张症:需要注意吗?
Pub Date : 2022-01-01 DOI: 10.4103/jgmh.jgmh_33_22
S. Grover
{"title":"Catatonia in the elderly: Does it require attention!","authors":"S. Grover","doi":"10.4103/jgmh.jgmh_33_22","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_33_22","url":null,"abstract":"","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"9 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41773272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinician's experience of telepsychiatry consultations with elderly patients 老年患者远程精神病学会诊的临床经验
Pub Date : 2022-01-01 DOI: 10.4103/jgmh.jgmh_31_22
Chandrima Naskar, S. Grover, A. Mehra, Swapnajeet Sahoo
Background: During the coronavirus disease-2019 pandemic, telepsychiatry became a norm as a primary method of health-care delivery across India. However, not much evidence is available regarding the experience of psychiatrists in providing a telepsychiatry consultation. Objective: This study aims to assess the experience and satisfaction of the clinician in providing teleconsultations to elderly patients/their caregivers. Methodology: Clinicians scored their experience, satisfaction, and their perception of therapeutic alliance in providing the teleconsultation to patients of age 60 years or more, in a detailed Google Forms-based questionnaire. Results: Ninety-eight teleconsultations were assessed by clinicians. The patients had a mean age of 69.5 years, with an equal number of males and females. In more than 80% of the teleconsultations, patients were accompanied by their relatives. In about one-fourth of the consultations, psychiatrists encountered connectivity issues from the patient side. Overall, for three-fourth (72%) of the teleconsultations, clinicians reported being satisfied to a large extent; for two-thirds (66%) of the consultations, the clinicians rated their teleconsultation experience as that of providing an in-person consultation; and for about 10% of consultations, the experience was rated as better than the in-person consultation. In terms of a therapeutic alliance, in almost 85%–90% of consultations, the clinicians noted that they could build a rapport, empathize with their patients, and build a relationship of trust with the patients and their caregivers. Conclusions: Teleconsultation with the elderly might not be as difficult as intuitively thought and clinicians are in general satisfied with the same and consider that they can establish a good therapeutic alliance with the patients and their caregivers.
背景:在2019冠状病毒病大流行期间,远程精神病学成为印度医疗保健的一种主要方法,成为常态。然而,关于精神科医生提供远程精神咨询的经验,没有太多证据。目的:本研究旨在评估临床医生为老年患者/其护理人员提供远程咨询的经验和满意度。方法:临床医生在一份基于谷歌表格的详细问卷中,对他们为60岁或以上的患者提供远程咨询的经验、满意度和对治疗联盟的看法进行评分。结果:临床医生对98次远程会诊进行了评估。患者的平均年龄为69.5岁,男女人数相等。在超过80%的远程会诊中,患者由其亲属陪同。在大约四分之一的咨询中,精神科医生遇到了患者方面的连接问题。总的来说,对于四分之三(72%)的远程会诊,临床医生报告在很大程度上感到满意;对于三分之二(66%)的咨询,临床医生将他们的远程咨询经验评为提供面对面的咨询;在约10%的咨询中,这种体验被评为比亲自咨询更好。就治疗联盟而言,在近85%-90%的咨询中,临床医生指出,他们可以建立融洽的关系,与患者感同身受,并与患者及其护理人员建立信任关系。结论:与老年人进行远程会诊可能不像直觉上想象的那样困难,临床医生通常对此感到满意,并认为他们可以与患者及其护理人员建立良好的治疗联盟。
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引用次数: 1
A comparison of post-COVID-19 psychiatric manifestations among adults and elderly 成人和老年人COVID-19后精神疾病表现的比较
Pub Date : 2022-01-01 DOI: 10.4103/jgmh.jgmh_35_22
M. Vaishnav, S. Grover, P. Vaishnav, G. Rao, G. Saha, A. Avasthi
Aim: This study aimed to estimate the prevalence of psychiatric morbidity in elderly patients recovered from coronavirus disease-2019 (COVID-19) infection, the present study aimed to compare the prevalence of psychiatric morbidity among elderly (aged ≥60 years) and adult patients (aged 18–59 years). Methodology: Two hundred and three elderly patients and 1714 adult participants had completed the Patient Health Questionnaire-9, generalized anxiety disorder-7 (GAD-7), Fear of COVID-19 Scale, Brief Resilient Coping Scale, The Brief Resilience Scale, and a self-designed questionnaire to assess the neuropsychiatric symptoms. Results: In the whole sample, the prevalence of depression was 34.4%, GAD was 32.6%, sleep disturbances were 58.3%, suicidal ideations were 23%, COVID-19-related fear was 32.1%, low resilience was 18.7%, and low resilient coping was 49.5%. Compared to adult participants, elderly participants had significantly higher prevalence and severity of depression, anxiety, COVID-19 fear score, low resilience, and low resilient coping. In the whole sample, the prevalence of posttraumatic stress disorder (PTSD) symptoms was 23.8%–25.3%, panic attacks were 17%, loneliness was 23.2%, forgetfulness was 21.8%, and cognitive slowing was 19%. Compared to the adult participants, significantly higher proportion of the elderly reported PTSD symptoms, cognitive slowing, and forgetfulness. Conclusions: Compared to adult subjects, elderly subjects who have recovered from COVID-19 infection have significantly higher prevalence of depression, anxiety, fear, post-traumatic symptoms, and cognitive symptoms. Hence, there is an urgent need to assess psychiatric morbidity among the elderly subject who have recovered from COVID-19 infection and institute interventions at the earliest to improve their mental health outcomes.
目的:本研究旨在评估2019冠状病毒病(COVID-19)感染后康复的老年患者的精神病学患病率,本研究旨在比较老年(≥60岁)和成年(18-59岁)患者的精神病学患病率。方法:对203例老年患者和1714名成人患者分别填写患者健康问卷-9、广泛性焦虑障碍-7 (GAD-7)、恐惧量表、简易弹性应对量表、简易弹性量表和自行设计的神经精神症状评估问卷。结果:在整个样本中,抑郁症患病率为34.4%,GAD患病率为32.6%,睡眠障碍患病率为58.3%,自杀意念患病率为23%,与covid -19相关的恐惧患病率为32.1%,低弹性患病率为18.7%,低弹性应对患病率为49.5%。与成年参与者相比,老年参与者的抑郁、焦虑、COVID-19恐惧评分、低弹性和低弹性应对的患病率和严重程度均显著高于成年参与者。在整个样本中,创伤后应激障碍(PTSD)症状的患病率为23.8%-25.3%,惊恐发作的患病率为17%,孤独的患病率为23.2%,健忘的患病率为21.8%,认知迟缓的患病率为19%。与成年参与者相比,老年人报告PTSD症状、认知减缓和健忘的比例明显更高。结论:与成年受试者相比,老年COVID-19感染康复者抑郁、焦虑、恐惧、创伤后症状和认知症状的患病率明显高于成年受试者。因此,迫切需要评估COVID-19感染后康复的老年受试者的精神疾病发病率,并尽早采取干预措施,以改善其心理健康状况。
{"title":"A comparison of post-COVID-19 psychiatric manifestations among adults and elderly","authors":"M. Vaishnav, S. Grover, P. Vaishnav, G. Rao, G. Saha, A. Avasthi","doi":"10.4103/jgmh.jgmh_35_22","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_35_22","url":null,"abstract":"Aim: This study aimed to estimate the prevalence of psychiatric morbidity in elderly patients recovered from coronavirus disease-2019 (COVID-19) infection, the present study aimed to compare the prevalence of psychiatric morbidity among elderly (aged ≥60 years) and adult patients (aged 18–59 years). Methodology: Two hundred and three elderly patients and 1714 adult participants had completed the Patient Health Questionnaire-9, generalized anxiety disorder-7 (GAD-7), Fear of COVID-19 Scale, Brief Resilient Coping Scale, The Brief Resilience Scale, and a self-designed questionnaire to assess the neuropsychiatric symptoms. Results: In the whole sample, the prevalence of depression was 34.4%, GAD was 32.6%, sleep disturbances were 58.3%, suicidal ideations were 23%, COVID-19-related fear was 32.1%, low resilience was 18.7%, and low resilient coping was 49.5%. Compared to adult participants, elderly participants had significantly higher prevalence and severity of depression, anxiety, COVID-19 fear score, low resilience, and low resilient coping. In the whole sample, the prevalence of posttraumatic stress disorder (PTSD) symptoms was 23.8%–25.3%, panic attacks were 17%, loneliness was 23.2%, forgetfulness was 21.8%, and cognitive slowing was 19%. Compared to the adult participants, significantly higher proportion of the elderly reported PTSD symptoms, cognitive slowing, and forgetfulness. Conclusions: Compared to adult subjects, elderly subjects who have recovered from COVID-19 infection have significantly higher prevalence of depression, anxiety, fear, post-traumatic symptoms, and cognitive symptoms. Hence, there is an urgent need to assess psychiatric morbidity among the elderly subject who have recovered from COVID-19 infection and institute interventions at the earliest to improve their mental health outcomes.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"9 1","pages":"43 - 53"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47755264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Geriatric Mental Health
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