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A retrospective chart analysis of 34 cases with the use of oral cerebroprotein hydrolysate in dementia in a tertiary general hospital 回顾性分析某三级综合医院口服脑水解蛋白治疗痴呆34例
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_10_20
S. Karia, A. Desousa, Nilesh Shah
Background: Cerebroprotein hydrolysate (cerebrolysin) is a nootropic and neurotrophic drug used widely in the management of various forms of dementia, stroke and head injury. A number of case series and anecdotal case reports on its efficacy exist. This study is a retrospective chart review of 34 patients with dementia treated at a tertiary general hospital psychiatry department that were given oral cerebroprotein as add on to their existing treatment for dementia. Methodology: 34 patients were administered twice daily oral cerebroprotein 90 mg tablets for 90 consecutive days. The cognitive assessment was done before the first injection and after the last dose using the Adenbrook's Cognitive Examination-Revised (ACER) and the Mini Mental Status Examination (MMSE). Results: Changes on cognitive assessment were minimal and no major improvements were seen though isolated areas of improvement were reported by many patients. The scores on the ACER and MMSE remained in the dementia range though improvement in scores were noted. None of the patients experienced any major side effects with the drug. Conclusions: Oral cerebroprotein is a useful agent in the management of dementia and must be tried as an add-on to regular dementia treatment. Larger studies in prospective cohorts with further stringent assessments warrant exploration.
背景:脑蛋白水解物(Cerebroprotein lysin)是一种益智和神经营养药物,广泛用于治疗各种形式的痴呆、中风和头部损伤。存在一些关于其疗效的病例系列和轶事病例报告。本研究回顾性分析了34例在三级综合医院精神科治疗的痴呆患者,这些患者在现有的痴呆治疗基础上口服脑蛋白。方法:34例患者口服脑蛋白90 mg片,每日2次,连续90天。认知评估在第一次注射前和最后一次注射后进行,使用Adenbrook认知检查-修订(ACER)和迷你精神状态检查(MMSE)。结果:认知评估的变化很小,虽然许多患者报告了孤立的改善区域,但没有看到重大的改善。ACER和MMSE的得分保持在痴呆范围内,尽管得分有所改善。所有患者都没有出现任何严重的药物副作用。结论:口服脑蛋白是治疗痴呆的有效药物,应作为常规痴呆治疗的补充。更大规模的前瞻性队列研究和进一步严格的评估值得探索。
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引用次数: 0
Elderly male with late-onset heroin dependence 老年男性迟发性海洛因依赖
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_12_21
A. Bhardwaj, S. Arya, S. Rathee, R. Gupta
Substance use disorders usually have their onset during the adolescent period. However, in rare cases environmental and psychosocial factors can contribute toward a later onset. We describe a case of an elderly male who initiated his heroin use for the first time at 65 years of age and eventually developed dependence. This late-onset of heroin use was mediated by contextual factors such as loneliness, boredom, and easy access to heroin while craving and withdrawal symptoms served as maintaining factors. He responded well to a combination of opioid antagonist and nonpharmacological approaches focusing on activity scheduling and social support. As the demographic transition and societal changes take place, the elderly population with substance use problems will increase. There is an urgent need to upgrade substance abuse treatment services to meet the specific needs of the elderly using supportive and nonconfrontational approaches with special focus on improving social support access.
物质使用障碍通常在青少年时期发病。然而,在极少数情况下,环境和社会心理因素可能导致发病晚。我们描述了一个老年男性谁开始他的海洛因使用第一次在65岁,并最终发展依赖的情况下。这种迟发性海洛因使用是由情境因素介导的,如孤独、无聊和容易获得海洛因,而渴望和戒断症状是维持因素。他对阿片类拮抗剂和关注活动安排和社会支持的非药物方法的组合反应良好。随着人口结构的转变和社会的变化,有药物使用问题的老年人口将会增加。迫切需要改进药物滥用治疗服务,以满足老年人的特殊需要,使用支持性和非对抗性的方法,特别注重改善获得社会支持的机会。
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引用次数: 0
Establishment of a geriatric clinic in psychiatry outpatient setting of a tertiary care hospital: Impact on care of elderly and training 在三级护理医院精神科门诊设置老年门诊:对老年人护理和培训的影响
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_17_21
S. Grover, Chandrima Naskar, S. Chakrabarti, A. Mehra, R. Nehra
Although there is a rapid increase in the elderly population in India, there is a lack of geriatric mental health services across the country. In India, although the postgraduation psychiatry program is available across many centers, little attention is paid to the subspecialty of geriatric psychiatry during the postgraduation training. There are very few courses (in the form of doctorate of medicine and fellowship programs) available in the subspecialty of geriatric psychiatry in the country. In this background, this paper focuses on the experience of establishing a geriatric clinic in a postgraduation psychiatry department and the impact of the same on patient care, research, and training in the area of geriatric psychiatry. The patient care data suggest that with the establishment of the geriatric clinic, there is an increase in the number of elderly patients admitted to the inpatient setting and those receiving electroconvulsive therapy. Further, there is an increase in the research in the area of geriatric psychiatry.
尽管印度老年人口迅速增加,但全国各地缺乏老年心理健康服务。在印度,虽然毕业后的精神病学项目在许多中心都有,但在毕业后的培训中,很少有人关注老年精神病学的亚专科。在这个国家,老年精神病学亚专科的课程(以医学博士学位和奖学金项目的形式)很少。在此背景下,本文将重点介绍在研究生精神科建立老年门诊的经验,以及对老年精神病学领域患者护理、研究和培训的影响。患者护理数据显示,随着老年门诊的建立,住院和接受电休克治疗的老年患者数量有所增加。此外,在老年精神病学领域的研究也有所增加。
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引用次数: 1
Association of of noncommunicable diseases on cognitive functioning: A comparative study 非传染性疾病对认知功能的影响:一项比较研究
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_9_21
A. Mehra, S. Rani, Swapnajeet Sahoo, R. Nehra, S. Grover
Aim: To compare the level of cognitive functioning among those with and without noncommunicable diseases (NCDs). Methodology: Using a cross-sectional study design, 104 patients attending the NCD clinic of a community rural health center and 101 elderly participants attending the hospital as caregivers of patients coming to the same community clinic with different ailments, were assessed on Hindi Mental State Examination (HMSE), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) scale. Results: Those with NCD performed poorly on all the domains of HMSE except orientation and registration. When the HMSE score of <25 was used to categorize the sample into those with and without cognitive impairment (CI), it was seen that the prevalence of CI was more among those with NCDs. The significant difference between the two groups persisted, even after controlling for age, gender, the income of the family, number of years of education, type of family, socioeconomic status, mean score of PHQ-9, and mean score of GAD-7. Conclusion: NCDs are negatively associated with cognitive functioning even after controlling for age, gender, the income of the family, number of years of education, type of family, socioeconomic status, mean score of PHQ-9, and mean score of GAD-7.
目的:比较非传染性疾病(NCDs)患者和非传染性疾病患者的认知功能水平。方法:采用横断面研究设计,采用印度精神状态检查(HMSE)、患者健康问卷-9 (PHQ-9)和广泛性焦虑障碍-7 (GAD-7)量表对104名在社区农村卫生中心非传染性疾病门诊就诊的患者和101名作为不同疾病患者的护理人员到同一社区诊所就诊的老年参与者进行评估。结果:非传染性疾病患者在HMSE的所有领域均表现较差,但定向和配准除外。当使用<25的HMSE评分将样本分为有认知障碍和无认知障碍(CI)时,可以看到CI的患病率在非传染性疾病患者中更高。即使在控制了年龄、性别、家庭收入、受教育年限、家庭类型、社会经济地位、PHQ-9平均得分和GAD-7平均得分之后,两组之间的显著差异仍然存在。结论:在控制了年龄、性别、家庭收入、受教育年限、家庭类型、社会经济地位、PHQ-9均分和GAD-7均分后,非传染性疾病仍与认知功能呈负相关。
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引用次数: 0
A comparative study of caregiver burden and stigma among the caregivers of patients with dementia and schizophrenia 痴呆和精神分裂症患者照护者负担和耻辱感的比较研究
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_10_21
S. Parveen, A. Mehra, Krishan Kumar, S. Grover
Aim: This study aimed to assess the level of stigma faced by the caregivers of patients with dementia. The secondary objective was to evaluate the association of stigma faced by the caregivers with caregiver burden and compare the stigma and caregiver burden encountered by the caregivers of patients with dementia and schizophrenia. Methodology: This was a cross-sectional study, 50 patients with dementia and their caregivers and 50 patients with schizophrenia and their caregivers. Diagnosis of both the disorders was made as per the Diagnostic and Statistical Manual, Fifth Revision. The study participants were assessed on the Stigma Scale for caregivers of people with mental illness and family burden interview schedule. Results: Caregivers of patients with schizophrenia had been in the caregiver role for a longer duration and were not on paid employment. Caregivers of patients with dementia were more often children of the patients. Caregivers of patients with dementia reported a significantly lower level of stigma in all the domains as well as reported lower total stigma score. The significant difference persisted even after controlling for demographic and caregiving variables. Similarly, caregivers of patients with schizophrenia reported a significantly higher level of burden on all the domains, except for effect on the domain of mental health of others which persisted even after controlling for demographic and caregiving variables. Conclusion: Caregivers of patients with dementia experience a lower level of stigma and caregiver burden, compared to patients with schizophrenia even after controlling for different confounding variables.
目的:本研究旨在评估痴呆症患者护理人员所面临的耻辱程度。次要目的是评估照顾者所面临的耻辱感与照顾者负担的关系,并比较痴呆和精神分裂症患者的照顾者所遇到的耻辱感和照顾者负担。方法:这是一项横断面研究,50名痴呆症患者和他们的照顾者以及50名精神分裂症患者和他们的照顾者。这两种疾病的诊断都是根据《诊断和统计手册》第五版进行的。采用精神疾病照顾者污名化量表和家庭负担访谈表对研究对象进行评估。结果:精神分裂症患者的照顾者处于照顾者角色的时间较长,且没有有偿就业。痴呆症患者的照顾者通常是患者的孩子。痴呆症患者的护理人员在所有领域报告了显著较低的耻辱感水平,并报告了较低的总耻辱感得分。即使在控制了人口统计学和护理变量之后,显著差异仍然存在。同样,精神分裂症患者的照顾者在所有领域都报告了显著更高的负担水平,除了对他人心理健康领域的影响,即使在控制了人口统计学和照顾变量之后,这种影响仍然存在。结论:与精神分裂症患者相比,痴呆患者的照顾者即使在控制了不同的混杂变量后,也会经历更低的耻辱感和照顾者负担。
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引用次数: 1
COVID-19 and cognitive impairment: A new challenge for the elderly 新冠肺炎与认知障碍:老年人面临的新挑战
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_31_21
S. Grover
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引用次数: 0
Recurrent idiopathic catatonia in an elderly patient with successful weaning off lorazepam 一名成功停用劳拉西泮的老年患者的复发性特发性紧张症
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_18_21
T. Panda, J. Aneja
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引用次数: 0
I wish she had dementia: Pandemic, lockdown, elderly with personality traits, and stress on families 我希望她患有痴呆症:大流行病、封锁、有个性特征的老年人以及家庭压力
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_14_21
S. Bharath
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引用次数: 0
Prevalence of metabolic syndrome in elderly patients with depression 老年抑郁症患者代谢综合征的患病率
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_8_21
S. Grover, Rahul Chakravarty, A. Mehra, S. Chakrabarti
Aim: To assess the prevalence of metabolic syndrome (MetS) in elderly patients with depressive disorder. Methodology: By using retrospective study design, the treatment records of all the elderly patients (aged ≥60 years) diagnosed with depressive disorders diagnosed as per the International Classification of Diseases, 10th Revision, were reviewed and data of patients for fasting blood glucose levels, lipid profile, and anthropometry (height, weight, waist circumference, and blood pressure [BP]) were extracted. The diagnosis of MetS was made as per the consensus criteria. Results: Data of 93 patients were included in the study. The mean age of the study participants was 65.65 (standard deviation [SD]: 5.61) years and the mean number of years of education was 8.33 (SD: 6.65) years. The mean duration of illness was 70.93 (SD: 107.39) months, with the mean duration of the current episode at the time of collection of data as 5.38 (SD: 3.54) months. More than half (57%) of the patients fulfilled the criteria for MetS. Besides more than half of the patients fulfilling the criteria for MetS, about one-tenth (9.7%) fulfilled one criterion, and one-third (32.3%) fulfilled 2 criteria for the MetS. The most common criteria of MetS which was fulfilled included abnormal waist circumference, followed by raised blood pressure, abnormal triglyceride levels, and abnormal high-density lipoprotein. Fasting blood glucose level was the least common abnormality. The presence of MetS was associated with a higher level of education, higher income, and presence of physical comorbidity. Conclusions: Considering that more than half of elderly patients with depressive illness also suffer from MetS, it is important to monitor elderly with depression for MetS, to reduce the risk of future cardiovascular morbidity and mortality.
目的:评估代谢综合征(MetS)在老年抑郁症患者中的患病率。方法:采用回顾性研究设计,回顾所有根据《国际疾病分类》第10版诊断为抑郁症的老年患者(年龄≥60岁)的治疗记录,并提取人体测量(身高、体重、腰围和血压[BP])。MetS的诊断符合一致标准。结果:93例患者的数据被纳入研究。研究参与者的平均年龄为65.65岁(标准差[SD]:5.61),平均受教育年限为8.33年(标准差:6.65)。疾病的平均持续时间为70.93(SD:107.39)个月,收集数据时当前发作的平均持续期为5.38(SD:3.54)个月。超过一半(57%)的患者符合MetS的标准。除了超过一半的患者符合MetS标准外,约十分之一(9.7%)符合一项标准,三分之一(32.3%)符合两项标准。MetS最常见的标准包括腰围异常,其次是血压升高、甘油三酯水平异常和高密度脂蛋白异常。空腹血糖水平是最不常见的异常。MetS的存在与较高的教育水平、较高的收入和身体共病的存在有关。结论:考虑到超过一半的老年抑郁症患者也患有代谢综合征,对老年抑郁症患者进行代谢综合征监测以降低未来心血管疾病发病率和死亡率的风险很重要。
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引用次数: 0
A study of cerebrovascular risk factors in depressive patients in old age 老年抑郁症患者脑血管危险因素的研究
Pub Date : 2021-01-01 DOI: 10.4103/jgmh.jgmh_34_18
Pyare Bhalothia, Paramjeet Singh, Banwari Mawlia, Sahiba Singh, Priyanka Jain
Context: Depression in late life is more likely to be associated with multiple medical comorbidities and cognitive impairment. In old-age hypertension, hyperlipidemia and obesity have been associated with cognitive impairment and vascular depression. The severity of vascular burden has a positive correlation with the severity of depression. Aims: This study aimed to find the association between cerebrovascular risk factors (CVRFs) and depression in old age. Methodology: A cross-sectional observational study was carried out at the outpatient department (OPD) of psychiatric center, SMS Medical College and Hospital, Jaipur. The patients from the OPD who provided informed consent were the participants in this study. Two hundred cases of depressive episode or recurrent depressive episode (unipolar depression) were included in the study. The diagnosis was made as per the International Classification of Diseases-10 criteria by two psychiatrists independently. Framingham CVRF prediction tool was applied to assess vascular burden. This was followed by statistical analysis. Results: The mean age of participants were 68.53 years, the mean score of Hamilton Depression Rating Scale (HAM-D) was 19.10 and the mean score of CVRFs was 13.13. HAM-D score positively correlates with CVRFs score (r = 0.188 and P = 0.008). Conclusions: Our study contributes to the growing literature elucidating the relationship of CVRFs in depressed older adults confirming that greater vascular burden can contribute to the severity of depression in geriatric depression.
背景:晚年抑郁症更可能与多种医学合并症和认知障碍有关。在老年高血压中,高脂血症和肥胖与认知障碍和血管性抑郁症有关。血管负荷的严重程度与抑郁症的严重程度呈正相关。目的:本研究旨在探讨脑血管危险因素(CVRFs)与老年抑郁症之间的关系。方法:在斋浦尔SMS医学院和医院精神病中心门诊部进行横断面观察性研究。提供知情同意书的门诊部患者是本研究的参与者。研究中包括了200例抑郁发作或复发性抑郁发作(单极性抑郁症)。该诊断是由两名精神科医生根据国际疾病分类-10标准独立做出的。Framingham CVRF预测工具用于评估血管负荷。随后进行了统计分析。结果:参与者的平均年龄为68.53岁,汉密尔顿抑郁量表(HAM-D)的平均得分为19.10,CVRFs的平均得分是13.13。HAM-D评分与CVRFs评分呈正相关(r=0.188,P=0.008)。结论:我们的研究有助于越来越多的文献阐明老年抑郁症患者CVRFs的关系,证实更大的血管负荷会导致老年抑郁症患者抑郁的严重程度。
{"title":"A study of cerebrovascular risk factors in depressive patients in old age","authors":"Pyare Bhalothia, Paramjeet Singh, Banwari Mawlia, Sahiba Singh, Priyanka Jain","doi":"10.4103/jgmh.jgmh_34_18","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_34_18","url":null,"abstract":"Context: Depression in late life is more likely to be associated with multiple medical comorbidities and cognitive impairment. In old-age hypertension, hyperlipidemia and obesity have been associated with cognitive impairment and vascular depression. The severity of vascular burden has a positive correlation with the severity of depression. Aims: This study aimed to find the association between cerebrovascular risk factors (CVRFs) and depression in old age. Methodology: A cross-sectional observational study was carried out at the outpatient department (OPD) of psychiatric center, SMS Medical College and Hospital, Jaipur. The patients from the OPD who provided informed consent were the participants in this study. Two hundred cases of depressive episode or recurrent depressive episode (unipolar depression) were included in the study. The diagnosis was made as per the International Classification of Diseases-10 criteria by two psychiatrists independently. Framingham CVRF prediction tool was applied to assess vascular burden. This was followed by statistical analysis. Results: The mean age of participants were 68.53 years, the mean score of Hamilton Depression Rating Scale (HAM-D) was 19.10 and the mean score of CVRFs was 13.13. HAM-D score positively correlates with CVRFs score (r = 0.188 and P = 0.008). Conclusions: Our study contributes to the growing literature elucidating the relationship of CVRFs in depressed older adults confirming that greater vascular burden can contribute to the severity of depression in geriatric depression.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"8 1","pages":"26 - 29"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48084214","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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