摘要:

Recent research findings demonstrate that general medical and mental health are inseparable in older individuals. The medical consequences of depression can be summarized with the unifying hypothesis that depression interacts with medical or neurological illness to modify the course of disease and to amplify its associated effects. The medical causes of depression can be divided into specific mechanisms of certain diseases or medications and general mechanisms that may integrate effects of a number of the common chronic disorders of late life. The authors discuss two general hypotheses: One suggests that depression may be associated with subclinical cerebrovascular disease in older patients with cerebrovascular risk factors; the other suggests that depression occurring in association with various conditions may be related to cytokine-mediated “sickness behavior.” The research literature makes a compelling case for the need to address psychiatric-medical comorbidity in late life as a central issue in public policy and the design of health care systems.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Geriatric psychiatry was the first subspecialty area for which The American Board of Psychiatry and Neurology, Inc. (ABPN) offered an examination for added qualifications. The American Board of Medical Specialties approved the proposed specialty in 1989, and the first examination was administered in 1991 to 661 candidates, and the second, 1 year later, to 578 candidates. This paper describes the test development and standard-setting procedures, test results, and candidates' feedback about the examination.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors report on a sample of 108 subjects over 60 years old who underwent cataract surgery and were assessed for cognitive and affective changes before surgery and at 1 week, 6 weeks, 6 months, and 1 year postoperatively. Cataract surgery did not predispose to significant cognitive deterioration in the perioperative period nor during the first postoperative year. However, objective vision changes, the subjective measure of adjustment to the effects of surgery, and a high depression score before surgery were significant predictors of depression at the end of the study year.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors document the lifetime prevalence and etiological correlates of alcohol abuse in a sample of elderly World War II veterans. Subjects (mean age 74.2 years), residing in a veterans' long-term care facility were given the Structured Clinical Interview for DSM-III-R. A second investigator gave the Modified Combat Exposure Scale and administered a checklist of pre-war and wartime variables. The lifetime prevalence of alcohol abuse was 53%. There was no correlation between alcohol abuse and any other psychiatric diagnosis. There was a significant correlation between the severity of combat stress and subsequent alcohol abuse. Veterans with alcohol abuse also had significantly more wartime head injuries. There was also a trend for the alcoholic group to have experienced more pre-war stressors. Examination of pre-war variables and the severity of the combat stress might help to identify veterans at risk for development of alcohol abuse.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Although there are a number of studies reporting the efficacy of cognitive-behavioral therapy for panic disorder in younger patients, such studies are lacking for older adults. This study used a subject sample (N = 20; 5 dropouts, 15 completers) of self-referred, community-dwelling older adults who met DSM-III-R criteria for panic disorder. Ten sessions of cognitive-behavioral therapy were provided over a 12-week period. Cognitive, behavioral, physiological, affective, and global domains (dimensions) were assessed by self-report measures. Statistically significant results of pretreatment, posttreatment, and 3-month follow-up means were found across domains, suggesting that treatment was efficacious.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors compared the frequency and severity of symptoms in subsyndromal and major depression after spousal bereavement in later life, as well as measures of social support, functional status, and grief intensity. Subsyndromal subjects (n = 25, mean age = 68.1) experienced fewer and less severe depressive symptoms and less functional impairment and anxiety than subjects with major depression (n = 25, mean age = 68.5). In a multivariate discriminant-function analysis (taking into account both symptom frequency and severity), mood, anxiety, early morning awakening, and weight loss correctly identified 92% of subsyndromal subjects and 92% of those with major depression. Further longitudinal study is under way to document the relationship of the current differences in symptomatology and clinical status to clinical outcome.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors identified neuropsychological tests appropriate for use in monitoring delirium severity in elderly patients. Ten elderly patients were administered a battery of tests while they were delirious and later during their recovery. All of the measures showed significant improvement across the two occasions (P < 0.05). Examination of components of variance suggests that modified versions of the Forward Digit Span, Similarities, or Oral Sentence Spelling tests or a combination of Forward Digit Span and Similarities or Oral Sentence Spelling are likely to be most effective in monitoring delirium severity.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Psychotic depression in younger patients has been associated with an increased rate of suicide, refractoriness to somatic treatment, and overall poor prognosis. However, the public health and scientific significance of this disorder in older patients has received limited attention in the past two decades; the topic was excluded from the 1991 NIH Consensus Development Conference on the Diagnosis and Treatment of Depression in Late Life. To address this obvious need in the field, a special work-group of recognized experts met in a special NIMH workshop to review and discuss clinical issues and key research questions. This is a report of that workshop's proceedings.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

To test the hypothesis that primary degenerative dementia of the Alzheimer type (PDD-AT) may increase the likelihood of expression of a lifetime vulnerability to the development of depression, the authors compared the premorbid rates of major depression in psychiatric inpatients with dementia, with or without a concurrent syndrome of depression. A premorbid history of major depression was four times more common in patients with the depressive syndrome of PDD-AT than in PDD-AT patients without depression. The authors discuss the significance of these findings for pathophysiologic models and estimates of comorbidity of depression in PDD-AT.

ISSN:1064-7481    

出版商:OVID    

年代:1996

数据来源: OVID