Background: Attitude toward psychotropic medications influences medication adherence. Although there are some data on attitude toward psychotropics among the adult patients, there is a lack of data on attitude of elderly patients toward psychotropic medications. Aim: The study aimed to evaluate the attitude of elderly patients toward psychotropic medications and compare the same with adult patients. Materials and Methodology: Attitude toward psychotropic medications of 102 elderly patients and 499 adult patients diagnosed with affective or psychotic disorders were compared using self-report attitude toward psychotropic medications questionnaire. Results: Compared to adult participants, higher proportion of elderly patients considered psychotropic medications to be the most effective way to treat mental illness and believed that psychotropics are a better option for treatment of mental illnesses than alternative treatments. Compared to adults, significantly lower proportion of the elderly believed that psychotropics do not cure but can lead to substantial improvement. In terms of negative attitude toward psychotropic medications, compared to adult participants, significantly higher proportion of the elderly believed that psychotropics are unnatural and poisonous substances which are harmful; psychotropics are just sedatives, which only calm down the patients; in long-run psychotropics worsen the illness; psychotropics can make the body unnaturally hot or cold; are expensive; make the subjects weak and enervated, and it is always better to take less than the prescribed dose of these medications. Compared to adults, elderly patients had significantly higher negative attitude subscale score. Conclusion: Compared to adult patients with affective and psychotic disorders, elderly patients have more negative attitude toward psychotropic medications. Hence, clinicians managing elderly patients should always evaluate the negative attitudes of the elderly toward psychotropic medications and try to address the same, to improve the medication adherence and outcome.
{"title":"Attitude toward psychotropic medications: A comparison of the elderly and adult patients with affective and psychotic disorders","authors":"S. Grover, A. Mehra, S. Chakrabarti, A. Avasthi","doi":"10.4103/jgmh.jgmh_36_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_36_19","url":null,"abstract":"Background: Attitude toward psychotropic medications influences medication adherence. Although there are some data on attitude toward psychotropics among the adult patients, there is a lack of data on attitude of elderly patients toward psychotropic medications. Aim: The study aimed to evaluate the attitude of elderly patients toward psychotropic medications and compare the same with adult patients. Materials and Methodology: Attitude toward psychotropic medications of 102 elderly patients and 499 adult patients diagnosed with affective or psychotic disorders were compared using self-report attitude toward psychotropic medications questionnaire. Results: Compared to adult participants, higher proportion of elderly patients considered psychotropic medications to be the most effective way to treat mental illness and believed that psychotropics are a better option for treatment of mental illnesses than alternative treatments. Compared to adults, significantly lower proportion of the elderly believed that psychotropics do not cure but can lead to substantial improvement. In terms of negative attitude toward psychotropic medications, compared to adult participants, significantly higher proportion of the elderly believed that psychotropics are unnatural and poisonous substances which are harmful; psychotropics are just sedatives, which only calm down the patients; in long-run psychotropics worsen the illness; psychotropics can make the body unnaturally hot or cold; are expensive; make the subjects weak and enervated, and it is always better to take less than the prescribed dose of these medications. Compared to adults, elderly patients had significantly higher negative attitude subscale score. Conclusion: Compared to adult patients with affective and psychotic disorders, elderly patients have more negative attitude toward psychotropic medications. Hence, clinicians managing elderly patients should always evaluate the negative attitudes of the elderly toward psychotropic medications and try to address the same, to improve the medication adherence and outcome.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"38 - 45"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42493232","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}
S. Grover, Swapnajeet Sahoo, A. Avasthi, Bhavesh M. Lakdawala, Amitava Dan, N. Nebhinani, A. Dutt, S. Tiwari, A. Gania, A. Subramanyam, Jahnavi S. Kedare, Navratan Suthar
Aim of the Study: This study aimed to evaluate the prevalence and risk factors for suicidal ideations (SIs) and suicidal attempts (SAs) among elderly patients with depression, seeking treatment in psychiatric setups. Methodology: The study sample comprised 488 elderly patients (age ≥60 years) with depression recruited across eight centers. These patients were evaluated on the Columbia Suicide Severity Rating Scale, Geriatric Depression Scale-30, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-15 Scale, UCLA Loneliness Scale, Revised Social Connectedness Scale, and Montreal Cognitive Assessment Scale. Results: “Wish to die” was present in one-fifth (21.7%) and about one-fourth (26.6%) of the study samples at the time of assessment and in the lifetime, respectively. Overall, one-fourth (25.8%; n = 126) of the participants had SIs at the time of assessment and two-fifths (41.5%; n = 203) had SIs in the lifetime. Overall, about one-tenth (9.2%) of the participants made an SA just before assessment and one-sixth (16.6%) had at least one SA in the lifetime. Compared to those with no SIs in the lifetime, those with current and lifetime SIs had lower age of onset and longer duration of illness, less often had a comorbid physical illness, more often had recurrent depressive disorder, had significantly higher anxiety as assessed on GAD-7 scale, and had significantly higher prevalence of loneliness and significantly higher prevalence of cognitive deficits. When those with any current and lifetime SAs and those with no lifetime SAs were compared, those with SAs had longer duration of current treatment and more often had comorbid physical illness and significantly higher cognitive deficits. Conclusions: The present study suggests that about one-fourth (25.8%) of the elderly with depression have SIs at the time of assessment and about two-fifths (41.5%) have lifetime SIs. About one-sixth of the elderly patients with depression make at least one SA in the lifetime and about one-tenth attempt suicide in recent past. In terms of risk factors for SIs and SAs, the present study suggests that the presence of comorbid anxiety, loneliness, and cognitive deficits possibly predispose the elderly to suicidal behaviors.
{"title":"Prevalence of suicidality and its correlates in geriatric depression: A multicentric study under the aegis of the Indian Association for Geriatric Mental Health","authors":"S. Grover, Swapnajeet Sahoo, A. Avasthi, Bhavesh M. Lakdawala, Amitava Dan, N. Nebhinani, A. Dutt, S. Tiwari, A. Gania, A. Subramanyam, Jahnavi S. Kedare, Navratan Suthar","doi":"10.4103/jgmh.jgmh_35_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_35_19","url":null,"abstract":"Aim of the Study: This study aimed to evaluate the prevalence and risk factors for suicidal ideations (SIs) and suicidal attempts (SAs) among elderly patients with depression, seeking treatment in psychiatric setups. Methodology: The study sample comprised 488 elderly patients (age ≥60 years) with depression recruited across eight centers. These patients were evaluated on the Columbia Suicide Severity Rating Scale, Geriatric Depression Scale-30, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-15 Scale, UCLA Loneliness Scale, Revised Social Connectedness Scale, and Montreal Cognitive Assessment Scale. Results: “Wish to die” was present in one-fifth (21.7%) and about one-fourth (26.6%) of the study samples at the time of assessment and in the lifetime, respectively. Overall, one-fourth (25.8%; n = 126) of the participants had SIs at the time of assessment and two-fifths (41.5%; n = 203) had SIs in the lifetime. Overall, about one-tenth (9.2%) of the participants made an SA just before assessment and one-sixth (16.6%) had at least one SA in the lifetime. Compared to those with no SIs in the lifetime, those with current and lifetime SIs had lower age of onset and longer duration of illness, less often had a comorbid physical illness, more often had recurrent depressive disorder, had significantly higher anxiety as assessed on GAD-7 scale, and had significantly higher prevalence of loneliness and significantly higher prevalence of cognitive deficits. When those with any current and lifetime SAs and those with no lifetime SAs were compared, those with SAs had longer duration of current treatment and more often had comorbid physical illness and significantly higher cognitive deficits. Conclusions: The present study suggests that about one-fourth (25.8%) of the elderly with depression have SIs at the time of assessment and about two-fifths (41.5%) have lifetime SIs. About one-sixth of the elderly patients with depression make at least one SA in the lifetime and about one-tenth attempt suicide in recent past. In terms of risk factors for SIs and SAs, the present study suggests that the presence of comorbid anxiety, loneliness, and cognitive deficits possibly predispose the elderly to suicidal behaviors.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"62 - 70"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43058829","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}
Background: Mental disorders have got high prevalence and low priority in most of the countries worldwide, of which depression among elderly population being the most common treatable medical condition. In developing countries such as India, there is a scarcity of adequately trained mental health professionals. In this context, validated Kannada version of the the Geriatric Depression Scale (KGDS)-15 is considered an alternative to screen the depression among the elderly. Objectives: The objectives of this study are to assess the psychometric properties of KGDS-15 in an urban community. Materials and Methods: A cross-sectional study was conducted in the urban field practice area of medical college, Bengaluru for a period of 6 months after the Institutional Ethics Committee clearance. House-to-house survey was done to enumerate the total number of the elderly; of 347 elderly, 100 elderly were selected by probability proportion to population size technique and linguistically validated KGDS-15 was applied to screen for depression, and psychiatrist assessed the depression status by clinical evaluation using the Structure Clinical Interview for DSM-IV and dementia status using the Mini-Mental Status Examination. Results: The KGDS-15 had 100% sensitivity and 88.8% specificity. The area under curve values for KGDS-15 was 0.98 (P < 0.0001), and the optimum cutoff score was >7, with a sensitivity of 1.0 and specificity of 0.95. The Cronbach's alpha is 0.92 and test-retest reliability is 0.99. Conclusions: The KGDS-15 had good psychometric properties and a valid instrument for screening depression among the elderly in the urban community.
背景:精神障碍在世界上大多数国家都是高发、低优先级的疾病，其中老年人抑郁症是最常见的可治疗疾病。在印度等发展中国家，缺乏训练有素的精神卫生专业人员。在此背景下，经验证的卡纳达语版老年抑郁症量表(KGDS)-15被认为是筛查老年人抑郁症的一种替代方法。目的:本研究的目的是评估KGDS-15在城市社区的心理测量特性。材料与方法:经机构伦理委员会批准后，在班加罗尔医学院的城市实地实习区进行了为期6个月的横断面研究。进行逐户调查，统计老人总数;在347名老年人中，采用概率比例法选择100名老年人，采用语言验证的KGDS-15进行抑郁筛查，精神科医师采用DSM-IV结构化临床访谈法对抑郁状态进行临床评估，采用Mini-Mental status Examination对痴呆状态进行评估。结果:KGDS-15的敏感性为100%，特异性为88.8%。KGDS-15的曲线值下面积为0.98 (P < 0.0001)，最佳临界值为bb0.7，敏感性为1.0，特异性为0.95。Cronbach’s alpha为0.92，重测信度为0.99。结论:KGDS-15量表具有良好的心理测量特性，是筛查城市社区老年人抑郁症的有效工具。
{"title":"Psychometric properties of the Geriatric Depression Scale (Kannada version): A community-based study","authors":"Jahnavi Rajgopal, T. Sanjay, M. Mahajan","doi":"10.4103/jgmh.jgmh_29_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_29_19","url":null,"abstract":"Background: Mental disorders have got high prevalence and low priority in most of the countries worldwide, of which depression among elderly population being the most common treatable medical condition. In developing countries such as India, there is a scarcity of adequately trained mental health professionals. In this context, validated Kannada version of the the Geriatric Depression Scale (KGDS)-15 is considered an alternative to screen the depression among the elderly. Objectives: The objectives of this study are to assess the psychometric properties of KGDS-15 in an urban community. Materials and Methods: A cross-sectional study was conducted in the urban field practice area of medical college, Bengaluru for a period of 6 months after the Institutional Ethics Committee clearance. House-to-house survey was done to enumerate the total number of the elderly; of 347 elderly, 100 elderly were selected by probability proportion to population size technique and linguistically validated KGDS-15 was applied to screen for depression, and psychiatrist assessed the depression status by clinical evaluation using the Structure Clinical Interview for DSM-IV and dementia status using the Mini-Mental Status Examination. Results: The KGDS-15 had 100% sensitivity and 88.8% specificity. The area under curve values for KGDS-15 was 0.98 (P < 0.0001), and the optimum cutoff score was >7, with a sensitivity of 1.0 and specificity of 0.95. The Cronbach's alpha is 0.92 and test-retest reliability is 0.99. Conclusions: The KGDS-15 had good psychometric properties and a valid instrument for screening depression among the elderly in the urban community.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"84 - 87"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42620747","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}
Introduction: India is going through a phase of demographic transition progressing to population aging. Poor health-related quality of life (QOL) among the elderly is often associated with physical deterioration, psychological trauma, and mental weakness. The rise in the social and health requirements of older adults has to be addressed optimally and comprehensively. Materials and Methods: A cross-sectional study was carried out on elderly individuals of urban Mangalore to determine their QOL. The multistage sampling design was used to obtain 384 elderlies aged 60 years or older. Results: The average QOL was observed among 74.3% of the elderly (mean score: 80.28–91.1). The factors such as age of the individual, gender, marital status, living status, education, occupation, socioeconomic status, interaction with people, use of mobile phones, and social media determined the QOL of the elderly (P < 0.001). Conclusion: Inclusionary measures such as participation in social clubs should be encouraged at the community level to enhance the QOL among the elderly population. Measures to improve the awareness of government schemes should be considered.
{"title":"Determinants of quality of life among the elderly population in urban areas of Mangalore, Karnataka","authors":"Shilpa Devraj, M. D'mello","doi":"10.4103/jgmh.jgmh_23_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_23_19","url":null,"abstract":"Introduction: India is going through a phase of demographic transition progressing to population aging. Poor health-related quality of life (QOL) among the elderly is often associated with physical deterioration, psychological trauma, and mental weakness. The rise in the social and health requirements of older adults has to be addressed optimally and comprehensively. Materials and Methods: A cross-sectional study was carried out on elderly individuals of urban Mangalore to determine their QOL. The multistage sampling design was used to obtain 384 elderlies aged 60 years or older. Results: The average QOL was observed among 74.3% of the elderly (mean score: 80.28–91.1). The factors such as age of the individual, gender, marital status, living status, education, occupation, socioeconomic status, interaction with people, use of mobile phones, and social media determined the QOL of the elderly (P < 0.001). Conclusion: Inclusionary measures such as participation in social clubs should be encouraged at the community level to enhance the QOL among the elderly population. Measures to improve the awareness of government schemes should be considered.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"94 - 98"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44502999","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}
35 Globally, more so in developing countries, the elderly population is rising. The increasing elderly population is posing its own challenges. One of the major challenges is multimorbidity. Multimorbidity is defined as “existence of multiple medical conditions in a single individual.”[1] Others have tried to define multimorbidity as an accumulation of two or more chronic diseases, whereas others have considered it to be the accumulation of three or more diseases.[2,3] In terms of chronicity, various diseases which have been included in the definition of multimorbidity include those which are considered to have permanence, are associated with disability, are associated with irreversible pathological changes in the body’s system, require long‐term supervision, observation, and care and are associated with special training needs for the patient’s rehabilitation.[2] Other authors have used the term long‐term conditions instead of chronic and defined the long‐term conditions like those, which cannot be cured but can be controlled by the use of medications or other treatments.[4] It is suggested that compared to those without multimorbidity, those with multimorbidity have a higher chance of functional decline, poorer quality of life, and more often use of health‐care services.[4] Some of the authors also suggest that there is a significant overlap between multimorbidity and frailty.[4] There are also some data to suggest that multimorbidity is associated with increased mortality.[5] Accordingly, those with multimorbidity are considered to be patients with complex healthcare needs, who have significantly higher healthcare needs, and pose a significant burden on the available health‐care services.[6]
{"title":"Multimorbidity in the elderly: Are we prepared for it!","authors":"S. Grover","doi":"10.4103/jgmh.jgmh_1_20","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_1_20","url":null,"abstract":"35 Globally, more so in developing countries, the elderly population is rising. The increasing elderly population is posing its own challenges. One of the major challenges is multimorbidity. Multimorbidity is defined as “existence of multiple medical conditions in a single individual.”[1] Others have tried to define multimorbidity as an accumulation of two or more chronic diseases, whereas others have considered it to be the accumulation of three or more diseases.[2,3] In terms of chronicity, various diseases which have been included in the definition of multimorbidity include those which are considered to have permanence, are associated with disability, are associated with irreversible pathological changes in the body’s system, require long‐term supervision, observation, and care and are associated with special training needs for the patient’s rehabilitation.[2] Other authors have used the term long‐term conditions instead of chronic and defined the long‐term conditions like those, which cannot be cured but can be controlled by the use of medications or other treatments.[4] It is suggested that compared to those without multimorbidity, those with multimorbidity have a higher chance of functional decline, poorer quality of life, and more often use of health‐care services.[4] Some of the authors also suggest that there is a significant overlap between multimorbidity and frailty.[4] There are also some data to suggest that multimorbidity is associated with increased mortality.[5] Accordingly, those with multimorbidity are considered to be patients with complex healthcare needs, who have significantly higher healthcare needs, and pose a significant burden on the available health‐care services.[6]","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"35 - 37"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48794738","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}
Context: Bipolar disorder (BD) in elderly individuals is a prevalent and disabling condition. The disorder also has an impact on the quality of life (QoL). However, very few studies have systematically examined the magnitude of QoL impairments in bipolar patients, especially in the older age group. Aims: The objective was to study the QoL and its correlation with sociodemographic factors and clinical variables in elderly BD patients. Settings and Design: A cross-sectional study was done in the psychiatry department at a tertiary hospital. Subjects and Methods: We examined QoL scores of 100 elderly (age range: 60–82 years) patients with BD on regular maintenance treatment for 1 year. Psychopathology was assessed using the Young Mania Rating Scale and Hamilton Rating Scale for Depression (HAM-D). QoL was assessed using QoL scale (World Health Organization QOL [WHO-BREF). Statistical Analysis Used: Statistical Package for the Social Sciences was used, and analysis of variables was done using unpaired t-test and Pearson correlation coefficient. Results: Female patients had significantly lower scores on physical and psychological domains in the WHO quality of life-BREF scale (P < 0.01). The unmarried/divorced/widowed population had lower QoL scores in the physical and social relationships domains (P < 0.01). Patients with lower socioeconomic status had lower QoL scores on physical and environmental domains of QoL (P < 0.05). There was significant negative correlation between the QoL and the total number of episodes (P < 0.05; R2 = 0.09) and between the QoL and duration of illness (P < 0.05; R2 = 0.05). Higher HAM-D scores were associated with poor QoL (P < 0.05; R2 = 0.07). Conclusions: This study offers insight into patterns of QoL in BD in the elderly. The study concludes that the duration of illness and the total number of episodes have a significant negative impact on QoL. Furthermore, undercurrent depressive features can be overlooked, leading to decline in the QoL.
{"title":"Quality of life in elderly bipolar disorder patients","authors":"D. Parikh, Smita N. Panse","doi":"10.4103/jgmh.jgmh_37_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_37_19","url":null,"abstract":"Context: Bipolar disorder (BD) in elderly individuals is a prevalent and disabling condition. The disorder also has an impact on the quality of life (QoL). However, very few studies have systematically examined the magnitude of QoL impairments in bipolar patients, especially in the older age group. Aims: The objective was to study the QoL and its correlation with sociodemographic factors and clinical variables in elderly BD patients. Settings and Design: A cross-sectional study was done in the psychiatry department at a tertiary hospital. Subjects and Methods: We examined QoL scores of 100 elderly (age range: 60–82 years) patients with BD on regular maintenance treatment for 1 year. Psychopathology was assessed using the Young Mania Rating Scale and Hamilton Rating Scale for Depression (HAM-D). QoL was assessed using QoL scale (World Health Organization QOL [WHO-BREF). Statistical Analysis Used: Statistical Package for the Social Sciences was used, and analysis of variables was done using unpaired t-test and Pearson correlation coefficient. Results: Female patients had significantly lower scores on physical and psychological domains in the WHO quality of life-BREF scale (P < 0.01). The unmarried/divorced/widowed population had lower QoL scores in the physical and social relationships domains (P < 0.01). Patients with lower socioeconomic status had lower QoL scores on physical and environmental domains of QoL (P < 0.05). There was significant negative correlation between the QoL and the total number of episodes (P < 0.05; R2 = 0.09) and between the QoL and duration of illness (P < 0.05; R2 = 0.05). Higher HAM-D scores were associated with poor QoL (P < 0.05; R2 = 0.07). Conclusions: This study offers insight into patterns of QoL in BD in the elderly. The study concludes that the duration of illness and the total number of episodes have a significant negative impact on QoL. Furthermore, undercurrent depressive features can be overlooked, leading to decline in the QoL.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"88 - 93"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41662332","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}
S. Chandra, N. Chakravarthula, V. Santosh, P. Mailankody, M. Mondal, D. Bhat, C. Vidhya Annapoorni, S. Narendiran, Praveen Sharma, D. Dhar, Naga Sudha Gorthi
Context: The aim is to awaken our colleagues to these reversible conditions. These are live saving if understood properly are life saving for patients. That is the purpose of this article and discussed in introduction. Aim: The aim of this study is to identify possible treatable causes in patients who present with progressive cognitive decline. These patients can be identified only by high degree of suspicion, thorough clinical examination and appropriate choosing of case-based investigations. This will be highly rewarding to the patients, their family, and to the treating physician. In this article, we are sharing our experience with the treatable dementias identified which were masquerading as degenerative. Settings and Design: Retrospective study. Subjects and Methods: Retrospective study of patients seen by the authors in the past 5 years who had all the mandatory recommended investigation done was included. Patients who qualified for pseudo-dementia and small vessel disease were not included in the analysis. Statistical Analysis Used: Basic statistical elements only were used as cases in each category are small. Results: Of 1105 patients, 92 had confirmed reversible cause. Among the treatable group immune-mediated dementia formed the largest and constituted about 45.6% followed by infections 19.5%, nutritional 15.2%, and rest were by rare conditions such as Whipple's disease, cerebrotendinious xanthamatosis, mitochondrial disorders, primary demyelination, central nervous system (CNS) lymphoma, surgical conditions such as normal pressure hydrocephalus and subdural hematoma. Conclusion: About 12.1% percentage of patients with memory complaint has a reversible cause which when detected early, the quality of life of both the patient and caregiver are significantly improved. Apart from protocol-based categorization of the patients, individualized thorough clinical examinations are mandatory to identify these patients.
{"title":"Look for the “Treatables” among dementias: It is lifesaving: An experience from a tertiary care center in India in the past 5 years","authors":"S. Chandra, N. Chakravarthula, V. Santosh, P. Mailankody, M. Mondal, D. Bhat, C. Vidhya Annapoorni, S. Narendiran, Praveen Sharma, D. Dhar, Naga Sudha Gorthi","doi":"10.4103/jgmh.jgmh_28_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_28_19","url":null,"abstract":"Context: The aim is to awaken our colleagues to these reversible conditions. These are live saving if understood properly are life saving for patients. That is the purpose of this article and discussed in introduction. Aim: The aim of this study is to identify possible treatable causes in patients who present with progressive cognitive decline. These patients can be identified only by high degree of suspicion, thorough clinical examination and appropriate choosing of case-based investigations. This will be highly rewarding to the patients, their family, and to the treating physician. In this article, we are sharing our experience with the treatable dementias identified which were masquerading as degenerative. Settings and Design: Retrospective study. Subjects and Methods: Retrospective study of patients seen by the authors in the past 5 years who had all the mandatory recommended investigation done was included. Patients who qualified for pseudo-dementia and small vessel disease were not included in the analysis. Statistical Analysis Used: Basic statistical elements only were used as cases in each category are small. Results: Of 1105 patients, 92 had confirmed reversible cause. Among the treatable group immune-mediated dementia formed the largest and constituted about 45.6% followed by infections 19.5%, nutritional 15.2%, and rest were by rare conditions such as Whipple's disease, cerebrotendinious xanthamatosis, mitochondrial disorders, primary demyelination, central nervous system (CNS) lymphoma, surgical conditions such as normal pressure hydrocephalus and subdural hematoma. Conclusion: About 12.1% percentage of patients with memory complaint has a reversible cause which when detected early, the quality of life of both the patient and caregiver are significantly improved. Apart from protocol-based categorization of the patients, individualized thorough clinical examinations are mandatory to identify these patients.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"46 - 61"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42912916","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}
Rishav Bansal, Sunny Singhal, G. Dewangan, Pramod Kumar, Sujata Satpathy, Nand Kumar, S. Dwivedi, A. Dey
Introduction: Diabetes is a known risk factor for mental health disorders in the older population. This effect can be due to direct impact of chronic disease or indirectly due to the impact of diabetic complications. This study aims to assess the association of individual diabetic complications with depression, generalized anxiety disorder (GAD), cognitive impairment, and quality of life (QOL) in older diabetic population. Materials and Methods: A cross-sectional study was performed in Geriatric Medicine OutPatient Department from November 2014 to June 2016. One hundred and eighty diabetic patients were diagnosed using the American Diabetes Association (ADA)-2015 diagnostic criteria and were included in the study. They were assessed for the presence of diabetic complications (diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, coronary artery disease , and cerebrovascular disease (CVD) as per the ADA-2015 guidelines. They were also subjected to assessment for the presence of depression, GAD, cognitive impairment, and health-related QOL by using Geriatric Depression Scale, Mini-International Neuropsychiatric Interview, Montreal Cognitive Assessment , and WHOQOL-BREF scale, respectively. The Chi-square test/Fisher's exact test and unpaired t-test were used for the statistical analysis. Results: Diabetic neuropathy and CVD in diabetes have higher risk of depression (49.3% vs. 27%; P = 0.002) and cognitive impairment (82.4% vs. 50.9%; P = 0.013), respectively, as compared to those with diabetes without such complications. Patients with diabetic nephropathy have poor environmental domain QOL (68.02 ± 15.16 vs. 72.82 ± 14.86; P = 0.040) as compared to those without diabetic nephropathy. Conclusions: Diabetic complications in old age are independently associated with increased risk of mental health disorders and impaired health-related QOL. Thus, patients with diabetic complications should be specifically assessed and managed for mental health disorders in addition to the management of metabolic abnormalities.
{"title":"Diabetic complications and poor mental health in the aging population","authors":"Rishav Bansal, Sunny Singhal, G. Dewangan, Pramod Kumar, Sujata Satpathy, Nand Kumar, S. Dwivedi, A. Dey","doi":"10.4103/jgmh.jgmh_22_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_22_19","url":null,"abstract":"Introduction: Diabetes is a known risk factor for mental health disorders in the older population. This effect can be due to direct impact of chronic disease or indirectly due to the impact of diabetic complications. This study aims to assess the association of individual diabetic complications with depression, generalized anxiety disorder (GAD), cognitive impairment, and quality of life (QOL) in older diabetic population. Materials and Methods: A cross-sectional study was performed in Geriatric Medicine OutPatient Department from November 2014 to June 2016. One hundred and eighty diabetic patients were diagnosed using the American Diabetes Association (ADA)-2015 diagnostic criteria and were included in the study. They were assessed for the presence of diabetic complications (diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, coronary artery disease , and cerebrovascular disease (CVD) as per the ADA-2015 guidelines. They were also subjected to assessment for the presence of depression, GAD, cognitive impairment, and health-related QOL by using Geriatric Depression Scale, Mini-International Neuropsychiatric Interview, Montreal Cognitive Assessment , and WHOQOL-BREF scale, respectively. The Chi-square test/Fisher's exact test and unpaired t-test were used for the statistical analysis. Results: Diabetic neuropathy and CVD in diabetes have higher risk of depression (49.3% vs. 27%; P = 0.002) and cognitive impairment (82.4% vs. 50.9%; P = 0.013), respectively, as compared to those with diabetes without such complications. Patients with diabetic nephropathy have poor environmental domain QOL (68.02 ± 15.16 vs. 72.82 ± 14.86; P = 0.040) as compared to those without diabetic nephropathy. Conclusions: Diabetic complications in old age are independently associated with increased risk of mental health disorders and impaired health-related QOL. Thus, patients with diabetic complications should be specifically assessed and managed for mental health disorders in addition to the management of metabolic abnormalities.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"78 - 83"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41631451","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}
Reminiscence therapy (RT) has been used over the past two decades extensively in the management of patients with dementia and geriatric depression. The following review study looks at the current role of RT in geriatric patients from a clinical perspective. The review elucidates the concept of reminiscence and looks at the historical aspects of RT. It also looks at the taxonomy and classification of the various types of reminiscences and RT techniques. The difference between reminiscence and life review is discussed. There are sections that look at the clinical role of RT in the management of patients with dementia and geriatric depression. The role of art therapy as a form of RT is discussed and elaborated. The existing literature on RT is reviewed, and certain recommendations for RT are made. There is also a slight deliberation on the need for RT in Indian settings. The role of RT as positive geriatric mental health intervention is also discussed.
{"title":"Reminiscence therapy in geriatric mental health care: A clinical review","authors":"P. Lodha, A. De Sousa","doi":"10.4103/jgmh.jgmh_1_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_1_19","url":null,"abstract":"Reminiscence therapy (RT) has been used over the past two decades extensively in the management of patients with dementia and geriatric depression. The following review study looks at the current role of RT in geriatric patients from a clinical perspective. The review elucidates the concept of reminiscence and looks at the historical aspects of RT. It also looks at the taxonomy and classification of the various types of reminiscences and RT techniques. The difference between reminiscence and life review is discussed. There are sections that look at the clinical role of RT in the management of patients with dementia and geriatric depression. The role of art therapy as a form of RT is discussed and elaborated. The existing literature on RT is reviewed, and certain recommendations for RT are made. There is also a slight deliberation on the need for RT in Indian settings. The role of RT as positive geriatric mental health intervention is also discussed.","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"7 - 13"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794038","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}
{"title":"Loneliness: Does it need attention!","authors":"S. Grover","doi":"10.4103/jgmh.jgmh_27_19","DOIUrl":"https://doi.org/10.4103/jgmh.jgmh_27_19","url":null,"abstract":"","PeriodicalId":16009,"journal":{"name":"Journal of Geriatric Mental Health","volume":"6 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793880","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}
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