Anxiety Symptoms in Older Adults with Depression Are Associated with Suicidality

2018 ◽  
Vol 45 (3-4) ◽  
pp. 180-189 ◽  
Author(s):  
Anette Bakkane Bendixen ◽  
Knut Engedal ◽  
Geir Selbæk ◽  
Cecilie Bhandari Hartberg
Keyword(s):  
Older Adults ◽  
Cognitive Functioning ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Medical Condition ◽  
Anxiety Symptoms ◽  
Clock Drawing Test ◽  
General Medical Condition ◽  
Icd 10 ◽  
Severity Of Depression

Objective: Anxiety symptoms are common in older adults with depression, but whether severe anxiety is associated with poorer outcomes of depression is unknown. The objective of the present study was to examine the association between severity of anxiety and severity of depression and physical illness, suicidality, and physical and cognitive functioning in older adults with depression. Methods: We included 218 older adults with diagnoses of a depressive disorder according to the ICD-10 criteria; their mean age (SD) was 75.6 (7.2), and 67.0% were women. The Geriatric Anxiety Inventory (GAI) was used to measure the severity of anxiety symptoms. The Montgomery-Aasberg Depression Rating Scale (MADRS) was used to assess the severity of depression. We obtained information on the level of functioning with the Physical Self-Maintenance Scale (PSMS) by Lawton and Brody and on cognition with the Mini-Mental State Examination (MMSE) and the Clock-Drawing Test (CDT). Physical health was determined based on information regarding falls and weight loss and an assessment of each patient’s general medical condition. The treating physician evaluated current suicidality in a comprehensive and standardized way. Results: Higher GAI scores were significantly associated with scores on the MADRS (β = 0.233, p = 0.002) and suicidality (β = 0.206, p = 0.006). Levels of physical or cognitive functioning were not associated with the GAI score. Conclusion: The severity of anxiety symptoms was associated with the severity of depression and suicidality in older adults with depressive disorders. The results could indicate a need to focus greater attention on the treatment of anxiety and suicidality in older patients with depression.

Does depression conciliate in marital adjustment?

2016 ◽  
Vol 33 (S1) ◽  
pp. S399-S399
Author(s):  
A. Channa
Keyword(s):  
Marital Satisfaction ◽  
Rating Scale ◽  
Marital Adjustment ◽  
Medical Condition ◽  
Satisfaction Scale ◽  
General Medical Condition ◽  
Duration Of Illness ◽  
Severity Of Depression ◽  
Marital Dissatisfaction ◽  
Competing Interest

Marriage is one of the principal facets when it comes to interpersonal context of depression. There is evidence supporting bidirectional casual effect between depression and marital satisfaction. However the phenomenon of marital adjustment and its related variable has not been given much attention in the Pakistan.ObjectiveTo determine the frequency of marital adjustment in patients with depression.MethodDepressed patients, who were aged between 15–65 were included. Patients who had documented co morbid of substance use or any unstable serious general medical condition were excluded. The severity of depression was evaluated by using Urdu validated Hamilton Depression Rating Scale. Marital adjustment is determined by using Urdu validated version of Kansas Marital Satisfaction Scale.ResultOnly 8.6% were well adjusted in their marital life, and all were females. The association of marital adjustment and severity of depression and difference in both genders on KANSAS was insignificant. The longer duration of illness was positively interrelated to the marital adjustment with odd ratio of 7.6. Being employed and above 30 years of age were inversely related to marital satisfaction with odd ratio of 6.1 and 5.4 respectively. However, the correlation between other independent variables and marital adjustment were insignificant in both genders.ConclusionThis study confirms the presence of high frequency i.e. 91.4% of marital dissatisfaction in depression in both male and females, irrespective of their severity of depression.Disclosure of interestThe author has not supplied their declaration of competing interest.

Association between severity of schizophrenic symptoms and urinary retention

2001 ◽  
Vol 16 (8) ◽  
pp. 497-500 ◽  
Author(s):  
R. Shiloh ◽  
A. Weizman ◽  
P. Dorfman-Etrog ◽  
N. Weizer ◽  
H. Munitz
Keyword(s):  
Urinary Retention ◽  
Rating Scale ◽  
Medical Condition ◽  
Paranoid Schizophrenia ◽  
Temporal Correlation ◽  
Continuous Treatment ◽  
Psychotic Symptoms ◽  
General Medical Condition ◽  
Haloperidol Treatment ◽  
Psychotic Exacerbation

SummaryA case is presented in which severe urinary retention (UR) occurred during an acute psychotic exacerbation of paranoid schizophrenia. The voiding dysfunction was apparent during continuous treatment with unchanged doses of haloperidol, and it completely resolved with the remission of the psychotic symptoms. A clear temporal correlation was evident between the patient’s mental status, the Brief Psychiatric Rating Scale (BPRS) score and the degree of the UR as assessed by quantitatively measuring the total daily postvoiding urine residues. We could not relate the UR to any apparent general medical condition or to the haloperidol treatment. The presented data suggests that UR in schizophrenic patients might be the end-result of various psychosis-related mechanisms.

scholarly journals Kriya Yoga in Patients with Depressive Disorders: A Pilot Study

2021 ◽  
Vol 12 (02) ◽  
pp. 362-367
Author(s):  
Ananya Srivastava ◽  
Pooja P. Kuppili ◽  
Tanu Gupta ◽  
Naresh Nebhinani ◽  
Ambika Chandani
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Remission Rate ◽  
Intervention Group ◽  
Control Group ◽  
Major Depressive ◽  
Yoga Intervention ◽  
Severity Of Depression

Abstract Background and Objectives Despite the easy acceptability and holistic nature of Kriya yoga, there are no studies evaluating the role of Kriya yoga intervention on depression. The objective of the current study was to assess the feasibility and effect of adjunctive Kriya yoga on depression. Methods Patients with major depressive disorder who opted for Kriya yoga were recruited into the intervention group (adjunctive Kriya yoga) and those on psychotropic medication alone were enrolled into the control group. The Hamilton Depression Rating Scale (HDRS) measurements were recorded at baseline, end of 2, 4, and 8 weeks. Results HDRS scores of the intervention group (n = 29) were found to be significantly lesser than that of the control group (n = 52) by the end of 2, 4, and 8 weeks. The remission rate was also significantly greater in the intervention group. Conclusion Kriya yoga intervention was found to be feasible, as well as improved the severity of depression.

scholarly journals Case Report: Use of Subcutaneous Midazolam During an Episode of Catatonia

2021 ◽  
Vol 12 ◽  
Author(s):  
Valentin Raymond ◽  
Etienne Véry ◽  
Adeline Jullien ◽  
Fréderic Eyvrard ◽  
Loic Anguill ◽  
...  
Keyword(s):  
Rating Scale ◽  
Medical Condition ◽  
Oral Treatment ◽  
First Episode ◽  
Polycystic Kidney ◽  
Anesthetic Induction ◽  
General Medical Condition ◽  
Injectable Treatment ◽  
History Of ◽  
Patient’S History

Midazolam is a benzodiazepine (BZD) mainly used in anesthetic induction due to its pharmacokinetic features. Its place in the therapeutic management of catatonia remains to be determined. Here we present the case of a 65-year-old man who presented with a first episode of catatonia with opposition to any form of oral treatment, where a single dose of 1 mg of subcutaneous (SC) Midazolam permitted clinical improvement allowing oral treatment to be given. The patient's history notably included a renal transplant linked to Polycystic Kidney Disease (PKD) and no history of psychiatric illness nor of any use of psychotropic drugs. As the patient refused to drink or eat and ceased answering basic questions, a psychiatric assessment was required. A diagnosis of Catatonic disorder due to a general medical condition [DSM 5–293.89/ ICD10 [F06.1]] was made. A Bush-Francis Catatonia Rating Scale (BFCRS) analysis returned a score of 15 out of 62, with stupor, mutism, negativism, staring, withdrawal, rigidity, and stereotypy. As the negativism prevented the patient from taking any form of oral treatment, after a brief discussion with the unit's physician, it was decided to administer 1 mg of SC Midazolam. One hour later, the patient was more responsive and compliant, and agreed to drink, eat, and take medication. Thus, the catatonic signs of mutism, negativism, staring, and withdrawal were resolved, but waxy flexibility and catalepsy appeared, leading to a new BFCRS score of 10 out of 62. Oral treatment with 2.5 mg Lorazepam, 4 times a day, was then initiated. Midazolam could be a safer choice compared with the other options available, such as other SC BZD, considering the complex safety profile of this patient with renal insufficiency. This situation represents the first report of using SC Midazolam as an injectable treatment for catatonia. More studies are needed to assess the clinical pertinence of SC Midazolam in the treatment of catatonia.

Lifestyle Factors, Cognitive Functioning, and Functional Capacity in Older Adults

2021 ◽  
pp. 009141502110094
Author(s):  
Anna S. Ord ◽  
Sue-Mei Slogar ◽  
Scott W. Sautter
Keyword(s):  
Older Adults ◽  
Physical Exercise ◽  
Sleep Quality ◽  
Cognitive Functioning ◽  
Functional Capacity ◽  
Rating Scale ◽  
Lifestyle Factors ◽  
Self Report ◽  
Exercise Habits ◽  
The Relationship

Research suggests that clinical management of cognitive impairment can occur through interventions targeting lifestyle factors, such as physical exercise and sleep quality. The present study examined the associations among lifestyle factors (exercise and sleep quality), cognition, and functional capacity in older adults (ages 56–94) who completed an outpatient neuropsychological evaluation ( N = 356). Exercise habits and sleep quality were accessed using a self-report questionnaire and a clinical interview. Cognitive functioning was assessed using the Dementia Rating Scale-2 (DRS-2). Functional capacity was measured by the Texas Functional Living Scale (TFLS). Results indicated that physical exercise and sleep quality were positively associated with better cognitive functioning and functional capacity. Further research is needed to elucidate the relationship between lifestyle factors, cognition, and functional capacity in older adults.

The period before hospitalization of patients with depressive disorders

2011 ◽  
Vol 26 (S2) ◽  
pp. 690-690
Author(s):  
E. Shmunk
Keyword(s):  
Psychiatric Hospital ◽  
Professional Training ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Structured Interview ◽  
Interview Guide ◽  
Icd 10 ◽  
Gastrointestinal Complaints ◽  
First Time ◽  
Depressive Patients

IntroductionDepressive disorders (DD) are common and disabling. Patients with DD often have to do a long way before seeing a mental health specialist.ObjectivesTo investigate characteristics of the period before hospitalization to psychiatric hospital of patients with DD.AimsTo define clinical peculiarities of DD, investigations, treatment of depressive patients before hospitalization.MethodsThe RDC of ICD-10 and «Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders Version» were used.ResultsAfter informed agreement 102 patients with DD for the first time admitted to the psychiatric hospital were examined. The average duration of DD before psychiatric examination was 19,1 months (up to 312 months). The average number of visits to primary care (PC) was 3,6 (up to 49), the average number of investigations was 2,4 (up to 8). The most part of visits to PC felt at patients with heart complaints (р = 0,02), the less to patients with loss of energy (р = 0,0007). With the prolongation of DD the number of investigations, medications in PC and absence days increased (r > 0,2, р < 0,05). Patients with heart and gastrointestinal complaints had more investigations (р = 0,01; р = 0,03). 38,2% of patients were prescribed tranquilizers and only 23,5% antidepressants, but 54,2% of them had suboptimal dossages.ConclusionsTo summarize, in real clinical practice patients with DD still haven’t enough opportunities for early diagnostics and treatment. Systematic recognition of patient with DD, professional training of PC doctors of different specialities are cruicial.

Chronic stress and anxiety-depressive spectrum disorders in patients of phoniatric practice

2011 ◽  
Vol 26 (S2) ◽  
pp. 2170-2170
Author(s):  
D. Veltishchev ◽  
A. Stukalo ◽  
S. Romanenko ◽  
O. Kovalevskaya ◽  
O. Seravina
Keyword(s):  
Chronic Stress ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Voice Disorders ◽  
Stress Factors ◽  
Traumatic Experience ◽  
External Control ◽  
Control Factors ◽  
Icd 10 ◽  
Spectrum Disorders

ObjectivesTo research the influence of stress factors on the development and circuit of voice disorders in their relation to anxiety and depressive spectrum.AimesTo analyze the extent to which the anxiety and depressive disorders are spreading among the patients with voice dysfunctions, to determine the variety of factors for psychological traumatic experience, and to distinguish the variety of anxiety and depressive disorders.MethodsThe Hospital Anxiety and Depression Rating Scale (HADS), the projective psychological tests.Preliminary HADS screening was conducted among 180 patients. More than half of the patients (57.5%) had high risk of anxiety and depressive disorders. 55 patients (44 women, 13 men, age of 18–70) with voice disorders and the positive results of screening were included to the study. Patients underwent a complete otolaryngologic examination and were grouped into organic voice pathology (34.5%) and non-organic voice pathology (65.5%). In accordance with ICD-10, anxiety and depressive disorders were diagnosed in 48 (87%) patients. In most cases (98.7%) the phoniatric pathology developed in chronic stress conditions. The prevailed chronic stress factors that provoked both anxiety-depressive spectrum disorders and voice pathology were inability to reach pre-set social goal (65.4%), ethical conflict (18.2%) and lack of external control factors (16.4%). Professional factor was also important as 38.2% of the group claimed heavy voice load at work.Chronic stress factors play significant provoking role in the development of voice and anxiety-depressive spectrum disorders, which should be taken into account to design diagnostic and therapeutic tactics for patients with voice pathology.

Illness burden and symptoms of anxiety in older adults: optimism and pessimism as moderators

2012 ◽  
Vol 24 (10) ◽  
pp. 1614-1621 ◽  
Author(s):  
Jameson K. Hirsch ◽  
Kristin L. Walker ◽  
Edward C. Chang ◽  
Jeffrey M. Lyness
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Rating Scale ◽  
Anxiety Symptoms ◽  
Medical Illness ◽  
Cross Sectional ◽  
Life Orientation Test ◽  
Medically Ill ◽  
Illness Burden ◽  
Health Related

ABSTRACTBackground: We assessed the association between medical illness burden and anxiety symptoms, hypothesizing that greater illness burden would be associated with symptoms of anxiety, and that optimism would buffer, while pessimism would exacerbate, this relationship.Methods: We recruited 109 older adults, aged 65 years and older, from primary care and geriatric clinics to participate in this cross-sectional, interview-based study. Participants completed the Snaith Clinical Anxiety Scale and the Life Orientation Test – Revised, a measure of optimism/pessimism. A physician-rated measure of illness burden, the Cumulative Illness Rating Scale, was also administered.Results: Supporting our hypotheses, greater levels of overall optimism weakened, and pessimism strengthened, the association between illness burden and anxiety symptoms, after accounting for the effects of demographic, cognitive, functional, and psychological covariates.Conclusions: Bolstering positive and reducing negative future expectancies may aid in the prevention of psychological distress in medically ill older adults. Therapeutic strategies to enhance optimism and reduce pessimism, which may be well-suited to primary care and other medical settings, and to which older adults may be particularly amenable, may contribute to reduced health-related anxiety.

Frailty and Depression in Late Life: A High-Risk Comorbidity with Distinctive Clinical Presentation and Poor Antidepressant Response

2021 ◽  
Author(s):  
Patrick J Brown ◽  
Adam Ciarleglio ◽  
Steven P Roose ◽  
Carolina Montes Garcia ◽  
Sarah Chung ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Depressive Disorders ◽  
Latent Class ◽  
Rating Scale ◽  
Controlled Trial ◽  
Antidepressant Medication ◽  
Biological Aging ◽  
Antidepressant Response ◽  
Previous Response

Abstract Background Investigate the longitudinal relationship between physical frailty, the clinical representation of accelerated biological aging, and antidepressant medication response in older adults with depressive illness. Methods An 8-week randomized placebo-controlled trial (escitalopram or duloxetine) followed by 10-months of open antidepressant medication treatment (augmentation, switch strategies) was conducted in an outpatient research clinic. 121 adults age &gt; 60 years with Major Depressive (MDD) or Persistent Depressive Disorders and a 24-item Hamilton Rating Scale for Depression (HRSD) &gt; 16 were enrolled. Primary measures assessed serially over 12-months include response (50% reduction from baseline HRSD score), remission (HRSD score &lt; 10), and frailty (non/intermediate frail [0-2 deficits] vs frail [&gt; 3 deficits]); latent class analysis was used to classify longitudinal frailty trajectories. Results A 2-class model best fit the data, identifying a consistently-low frailty-risk (63% of the sample) and consistently-high frailty-risk (37% of the sample) trajectory. Response and remission rates (P’s&lt;.002) for adults in the high-risk frailty class were at least 21 percentage-points worse than those in the low-risk class over 12-months. Furthermore, subsequent frailty was associated with previous frailty (P’s &lt; .01) but not previous response or remission (P’s &gt; .10). Conclusions Antidepressant medication is poorly effective for MDD occurring in the context of frailty in older adults. Furthermore, even when an antidepressant response is achieved, this response does little to improve their frailty. These data suggest that standard psychiatric assessment of depressed older adults should include frailty measures and that novel therapeutic strategies to address comorbid frailty and depression are needed.

Mild cognitive impairment

2012 ◽  
pp. 1534-1539
Author(s):  
Claudia Jacova ◽  
Howard H. Feldman
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Common Ground ◽  
Medical Condition ◽  
Cognitive Disorder ◽  
General Medical Condition ◽  
Classification Framework ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Dsm Iv

Within the cognitive functioning continuum from normal ageing to dementia three broad states can be distinguished: normal functioning for age, clear-cut impairment meeting diagnostic criteria for dementia, and mild cognitive impairment (MCI), which falls below normal but short of dementia in severity (Fig. 8.5.1.1.1). There is active debate over what MCI is, how to define and classify this state, and where to set its borders on the described continuum. Some definitions depict MCI as the tail-end of normal cognitive ageing whereas in other definitions MCI embodies the early clinical manifestation of Alzheimer Disease (AD) and other dementias. In 2003, the key elements of different MCI definitions were integrated into a consensus diagnostic and classification framework, thus establishing some common ground in a field that is still evolving. MCI has also been positioned as a potentially important target for early treatment interventions to delay progression to dementia. Nosologically, MCI is not currently included as a diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the International Classification of Diseases, 10th revision. The diagnostic categories of Mild Neurocognitive Disorder (DSM-IV-TR) and Mild Cognitive Disorder (ICD-10) are similar to MCI because they require the presence of cognitive impairment but these categories can only be assigned if a specific neurological or general medical condition can be identified to account for the cognitive symptoms. Much of the current condition of MCI does not fit as it has no aetiologic specification. Nevertheless, MCI is increasingly a presenting condition in primary and specialized settings of care. Medical practice guidelines have recognized MCI as a risk state for dementia and recommend careful clinical evaluation and monitoring of individuals with this diagnosis.

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