Pastoral Care for the Aged: A Practical Guide

There are three potential dangers to mental health in old age: chronic physical conditions, retirement, and changing family relationships. These conditions can result in various pathological manifestations: rigidity, hypochondria, paranoia, depression, and institutional neurosis. Religion is a positive force for mental health in old age, and there is much that a pastoral counselor can do in geriatric cases. An eight-step plan is recommended for pastoral care: (1) define the scope of fruitful intervention; (2) direct your opening remarks to the elder; (3) objectively take a history; (4) identify problems; (5) solve the problems directly; (6) resolve guilt complexes; (7) provide opportunities for socialization and emotional support; (8) refer cases when necessary.

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Trajectories of mental health symptoms for women in their 20s predict the onset of chronic physical conditions in their 30s: Two decades of follow-up of young Australian women

Journal of Affective Disorders ◽

10.1016/j.jad.2018.12.106 ◽

2019 ◽

Vol 246 ◽

pp. 394-400 ◽

Cited By ~ 2

Author(s):

Xiaolin Xu ◽

Gita D. Mishra ◽

Mark Jones

Keyword(s):

Mental Health ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Physical Conditions ◽

Chronic Physical Conditions

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Mental-Physical Comorbidity in Te Rau Hinengaro: The New Zealand Mental Health Survey

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2006.01907.x ◽

2006 ◽

Vol 40 (10) ◽

pp. 882-888 ◽

Cited By ~ 1

Author(s):

Kate M. Scott ◽

Mark A. Oakley Browne ◽

Magnus A. Mcgee ◽

J. Elisabeth Wells ◽

Keyword(s):

Mental Health ◽

Risk Factors ◽

Cardiovascular Disease ◽

New Zealand ◽

Mental Disorders ◽

Mental Disorder ◽

Composite International Diagnostic Interview ◽

Hazardous Alcohol Use ◽

Physical Conditions ◽

Chronic Physical Conditions

Objective: To estimate the prevalence of chronic physical conditions, and the risk factors for those conditions, among those with 12 month mental disorder; to estimate the prevalence of 12 month mental disorder among those with chronic physical conditions. Method: A nationally representative face-to-face household survey was carried out in October 2003 to December 2004 with 12 992 participants aged 16 years and over, achieving a response rate of 73.3%. Mental disorders were measured with the World Mental Health version of the Composite International Diagnostic Interview (CIDI 3.0). Physical conditions were self-reported. All associations are reported adjusted for age and sex. Results: People with (any) mental disorder, relative to those without mental disorder, had higher prevalences of several chronic physical conditions (chronic pain, cardiovascular disease, high blood pressure and respiratory conditions) and chronic condition risk factors (smoking, overweight/obesity, hazardous alcohol use). Around a quarter of people with chronic physical conditions had a comorbid mental disorder compared with 15% of the population without chronic conditions. Significant relationships occurred between some mental disorders and obesity, cardiovascular disease and diabetes for females, but not for males. Conclusions: This paper provides evidence of substantial comorbidity between mental disorders and chronic physical conditions in New Zealand. This should be borne in mind by clinicians working in both mental health and medical services.

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Depression–anxiety relationships with chronic physical conditions: Results from the World Mental Health surveys

Journal of Affective Disorders ◽

10.1016/j.jad.2007.01.015 ◽

2007 ◽

Vol 103 (1-3) ◽

pp. 113-120 ◽

Cited By ~ 257

Author(s):

K.M. Scott ◽

R. Bruffaerts ◽

A. Tsang ◽

J. Ormel ◽

J. Alonso ◽

...

Keyword(s):

Mental Health ◽

Health Surveys ◽

Physical Conditions ◽

World Mental Health ◽

The World ◽

Chronic Physical Conditions

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Affective and Anxiety Disorders and their Relationship with Chronic Physical Conditions in Australia: Findings of the 2007 National Survey of Mental Health and Wellbeing

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048674.2011.614590 ◽

2011 ◽

Vol 45 (11) ◽

pp. 939-946 ◽

Cited By ~ 32

Author(s):

Maree Teesson ◽

Philip B. Mitchell ◽

Mark Deady ◽

Sonja Memedovic ◽

Tim Slade ◽

...

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

National Survey ◽

Physical Condition ◽

Service Use ◽

Health And Wellbeing ◽

Physical Conditions ◽

Chronic Physical Conditions ◽

Nationally Representative

Objective: The aim of this study was to report nationally representative data on the prevalence and patterns of 12 month comorbidity of chronic physical conditions (diabetes, asthma, coronary heart disease, stroke, cancer, arthritis) and DSM-IV affective and anxiety disorders in Australian adults. Method: The 2007 National Survey of Mental Health and Wellbeing (NSMHWB) was a nationally representative household survey of 8841 Australian adults (16–85 years) assessing symptoms of ICD-10 mental disorders and the presence of chronic physical conditions. Results: Prevalence of at least one National Health Priority Area chronic physical condition was 32.2% (95%CI = 30.9%–33.5%). Among those with chronic physical conditions 21.9% had an affective or anxiety disorder. Affective and anxiety disorders were more common among people with physical conditions than among people without chronic physical conditions (affective OR 1.5; anxiety OR 1.8). Of those with a 12 month affective or anxiety disorder, 45.6% had a chronic physical condition. Physical disorders were more common in those with an affective or anxiety disorder than among people without an affective or anxiety disorder (affective OR 1.6; anxiety OR 2.0). Disability was high in those with an anxiety disorder, an affective disorder and a physical condition and 43.4% were classified as high service users. Conclusions: Comorbidity between chronic physical conditions and affective and anxiety disorders is widespread and is associated with high levels of disability and service use.

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Does Having a Chronic Physical Condition Affect the Likelihood of Treatment Seeking for a Mental Health Problem and Does This Vary by Ethnicity?

The International Journal of Psychiatry in Medicine ◽

10.2190/pm.42.4.f ◽

2011 ◽

Vol 42 (4) ◽

pp. 421-436 ◽

Cited By ~ 3

Author(s):

K. M. Scott ◽

J. Kokaua ◽

J. Baxter

Keyword(s):

Mental Health ◽

New Zealand ◽

Mental Disorders ◽

Physical Condition ◽

Mental Health Treatment ◽

Treatment Seeking ◽

Health Treatment ◽

Physical Conditions ◽

Ethnic Subgroups ◽

Chronic Physical Conditions

Objective: The comorbidity of mental disorders with chronic physical conditions is known to have important clinical consequences, but it is not known whether mental-physical comorbidity influences mental health treatment seeking. This study investigates whether the presence of a chronic physical condition influences the likelihood of seeking treatment for a mental health problem, and whether that varies among ethnic subgroups in New Zealand. Methods: Analyses were based on a subsample ( n = 7,435) of The New Zealand Mental Health Survey, a nationally representative household survey of adults (response rate 73.3%). Ethnic subgroups (Maori and Pacific peoples) were oversampled. DSM-IV mental disorders were measured face-to-face with the Composite International Diagnostic Interview (CIDI 3.0). Ascertainment of chronic physical conditions was via self-report. Results: In the general population, having a chronic medical condition increased the likelihood of seeking mental health treatment from a general practitioner (OR: 1.58), as did having a chronic pain condition (OR: 2.03). Comorbid chronic medical conditions increased the likelihood of seeking mental health treatment most strongly among Pacific peoples (ORs: 2.86–4.23), despite their being less likely (relative to other ethnic groups) to seek mental health treatment in the absence of physical condition comorbidity. Conclusion: In this first investigation of this topic, this study finds that chronic physical condition comorbidity increases the likelihood of seeking treatment for mental health problems. This provides reassurance to clinicians and health service planners that the difficult clinical problem of mental-physical comorbidity is not further compounded by the comorbidity itself constituting a barrier to mental health treatment seeking.

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A Reduction in Health Care Expenditures Linked to Mental Health Service Use Among Adults With Chronic Physical Conditions

Psychiatric Services ◽

10.1176/appi.ps.202000161 ◽

2021 ◽

pp. appi.ps.2020001

Author(s):

Linh N. Bui ◽

Jangho Yoon ◽

Denise M. Hynes

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Service ◽

Health Service ◽

Service Use ◽

Health Care Expenditures ◽

Mental Health Service Use ◽

Health Service Use ◽

Physical Conditions ◽

Chronic Physical Conditions

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ASSOCIATIONS BETWEEN CHRONIC PHYSICAL CONDITIONS, MEDICATIONS AND MENTAL HEALTH IN AN AGING COHORT

Innovation in Aging ◽

10.1093/geroni/igz038.2309 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S620-S620

Author(s):

Lucy Stirland ◽

Lucy E Stirland ◽

Tom C Russ ◽

Craig W Ritchie ◽

Graciela Muniz Terrera

Keyword(s):

Mental Health ◽

Additional Condition ◽

Epidemiologic Studies ◽

Multiple Chronic Conditions ◽

Depression And Anxiety ◽

Brain Health ◽

Physical Conditions ◽

Crucial Information ◽

Chronic Physical Conditions ◽

Study Participants

Abstract Older people increasingly live with multiple chronic conditions and medications. We explored their interactions with mental health in the PREVENT Dementia study participants. Using logistic and linear regression, we investigated the association between increasing self-reported chronic physical conditions and current medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest. Among 210 participants, each additional condition was associated with increased odds of depression (adjusted OR, 95% CI: 1.41, 1.11-1.80; P=0.005) and anxiety (1.71, 1.35-2.21; P<0.001). Each additional medication was associated with depression (1.36, 1.07-1.73; P=0.010) but not anxiety. For each additional condition, CES-D scores increased by 0.62 (0.04-1.20, P=0.035) and for each medication, by 0.66 (0.12-1.21, P=0.017). There was no significant association between conditions or medications and STAI scores. These findings provide crucial information on the future brain health of these individuals.

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Pastoral care in old age psychiatry: Addressing the spiritual needs of inpatients in an acute aged mental health unit

Asia-Pacific Psychiatry ◽

10.1111/appy.12018 ◽

2012 ◽

Vol 6 (2) ◽

pp. 127-134 ◽

Cited By ~ 6

Author(s):

Anita M.Y. Goh ◽

Tamara Eagleton ◽

Rosemary Kelleher ◽

Olga Yastrubetskaya ◽

Michael Taylor ◽

...

Keyword(s):

Mental Health ◽

Pastoral Care ◽

Old Age ◽

Spiritual Needs ◽

Health Unit ◽

Old Age Psychiatry ◽

Mental Health Unit

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Potentially preventable hospitalisations for physical health conditions in community mental health service users: a population-wide linkage study

Epidemiology and Psychiatric Sciences ◽

10.1017/s204579602100007x ◽

2021 ◽

Vol 30 ◽

Author(s):

G. Sara ◽

W. Chen ◽

M. Large ◽

P. Ramanuj ◽

J. Curtis ◽

...

Keyword(s):

Mental Health ◽

Health Service ◽

Physical Health ◽

Health Conditions ◽

Community Mental Health Service ◽

Service Users ◽

Physical Conditions ◽

Age Related ◽

Chronic Physical Conditions ◽

Hospital Days

Abstract Aims Mental health (MH) service users have increased prevalence of chronic physical conditions such as cardio-respiratory diseases and diabetes. Potentially Preventable Hospitalisations (PPH) for physical health conditions are an indicator of health service access, integration and effectiveness, and are elevated in long term studies of people with MH conditions. We aimed to examine whether PPH rates were elevated in MH service users over a 12-month follow-up period more suitable for routine health indicator reporting. We also examined whether MH service users had increased PPH rates at a younger age, potentially reflecting the younger onset of chronic physical conditions. Methods A population-wide data linkage in New South Wales (NSW), Australia, population 7.8 million. PPH rates in 178 009 people using community MH services in 2016–2017 were compared to population rates. Primary outcomes were crude and age- and disadvantage-standardised annual PPH episode rate (episodes per 100 000 population), PPH day rate (hospital days per 100 000) and adjusted incidence rate ratios (AIRR). Results MH service users had higher rates of PPH admission (AIRR 3.6, 95% CI 3.5–3.6) and a larger number of hospital days (AIRR 5.2, 95% CI 5.2–5.3) than other NSW residents due to increased likelihood of admission, more admissions per person and longer length of stay. Increases were greatest for vaccine-preventable conditions (AIRR 4.7, 95% CI 4.5–5.0), and chronic conditions (AIRR 3.7, 95% CI 3.6–3.7). The highest number of admissions and relative risks were for respiratory and metabolic conditions, including chronic obstructive airways disease (AIRR 5.8, 95% CI 5.5–6.0) and diabetic complications (AIRR 5.4, 95% CI 5.1–5.8). One-quarter of excess potentially preventable bed days in MH service users were due to vaccine-related conditions, including vaccine-preventable respiratory illness. Age-related increases in risk occurred earlier in MH service users, particularly for chronic and vaccine-preventable conditions. PPH rates in MH service users aged 20–29 were similar to population rates of people aged 60 and over. These substantial differences were not explained by socio-economic disadvantage. Conclusions PPHs for physical health conditions are substantially increased in people with MH conditions. Short term (12-month) PPH rates may be a useful lead indicator of increased physical morbidity and less accessible, integrated or effective health care. High hospitalisation rates for vaccine-preventable respiratory infections and hepatitis underline the importance of vaccination in MH service users and suggests potential benefits of prioritising this group for COVID-19 vaccination.

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