Avaliação da capacidade de decisão de idosos diagnosticados com depressão maior

*** Assessment of the decision-making capacity of elderly individuals diagnosed with major depression ***AIMS: To verify if there are changes in the decision-making capacity of elderly patients with major depression.METHODS: This is a prospective cohort study with an initial cross-sectional analysis conducted between January 2014 and September 2015. Treatment-naïve elderly patients from the Cerebral Aging Outpatient Clinic at PUCRS São Lucas Hospital, in Porto Alegre, Brazil, all diagnosed with major depressive disorder, were selected. The control group was composed of elderly individuals from the same community who had neither depression nor cognitive problems. For evaluation of the decision-making capacity, the Assessment Scale for Decision-Making Capacity was designed and validated in a previous stage of the research. This instrument is divided into four domains: daily activity, financial management, self-management, and well-being. The Geriatric Depression Scale (short version) and the Mini-International Neuropsychiatric Interview (detailed version) were used to evaluate the presence of depression. The Vellore Screening Instrument for Dementia and the Addenbrooke’s Cognitive Examination (revised version) were applied to evaluate cognitive decline. Decision-making capacity was compared between the two groups of elderly individuals. The same evaluation was conducted with elderly patients with depression after six months of psychiatric treatment. The statistical analysis included Student’s t, Pearson’s chi-square, Mann-Whitney, and Wilcoxon tests. Statistical significance was set at p≤0.05.RESULTS: Forty-eight elderly patients with major depression and 144 elderly individuals from the control group participated in the study. The Assessment Scale for Decision-Making Capacity average score in depression patients was 70.5±17.9, compared to 94.6±9.6 (p<0.001) in the control group, which indicates poorer decision-making capacity among patients with major depression. The domains with the most striking differences in the average scores were self-management (depression patients 65.0±23.3 and control group 97.8±6.2) and well-being (depression patients 52.2±27.1 and control group 91.8±16.7). When comparing patients with depression before and after treatment, regarding both the general score and the four domains of the Assessment Scale for Decision-Making Capacity, the decision-making capacity was higher after the treatment.CONCLUSIONS: The group of elderly patients with current major depression had a lower decision-making capacity compared to the control group. Their decision-making capacity improved after six months of psychiatric treatment.

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Peripandemic psychiatric emergencies: impact of the COVID-19 pandemic on patients according to diagnostic subgroup

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/s00406-020-01228-6 ◽

2021 ◽

Vol 271 (2) ◽

pp. 259-270

Author(s):

Johanna Seifert ◽

Catharina Meissner ◽

Anna Birkenstock ◽

Stefan Bleich ◽

Sermin Toto ◽

...

Keyword(s):

Psychiatric Treatment ◽

Somatoform Disorders ◽

Presentation Rate ◽

Well Being ◽

Control Group ◽

Medical Care System ◽

Persecutory Delusions ◽

Vulnerable Patients ◽

Group A ◽

Repeat Visits

AbstractOn March 11th, 2020, the outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic. Governments took drastic measures in an effort to reduce transmission rates and virus-associated morbidity. This study aims to present the immediate effects of the pandemic on patients presenting in the psychiatric emergency department (PED) of Hannover Medical School. Patients presenting during the same timeframe in 2019 served as a control group. A decrease in PED visits was observed during the COVID-19 pandemic with an increase in repeat visits within 1 month (30.2 vs. 20.4%, pBA = 0.001). Fewer patients with affective disorders utilized the PED (15.2 vs. 22.2%, pBA = 0.010). Suicidal ideation was stated more frequently among patients suffering from substance use disorders (47.4 vs. 26.8%, pBA = 0.004), while patients with schizophrenia more commonly had persecutory delusions (68.7 vs. 43.5%, pBA = 0.023) and visual hallucinations (18.6 vs. 3.3%, pBA = 0.011). Presentation rate of patients with neurotic, stress-related, and somatoform disorders increased. These patients were more likely to be male (48.6 vs. 28.9%, pBA = 0.060) and without previous psychiatric treatment (55.7 vs. 36.8%, pBA = 0.089). Patients with personality/behavioral disorders were more often inhabitants of psychiatric residencies (43.5 vs. 10.8%, pBA = 0.008). 20.1% of patients stated an association between psychological well-being and COVID-19. Most often patients suffered from the consequences pertaining to social measures or changes within the medical care system. By understanding how patients react to such a crisis situation, we can consider how to improve care for patients in the future and which measures need to be taken to protect these particularly vulnerable patients.

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Parenting Stress and Need Assessment of Families with Disabled Children across Himachal Himalaya

International Journal of Social Science Research ◽

10.5296/ijssr.v3i2.7344 ◽

2015 ◽

Vol 3 (2) ◽

pp. 38 ◽

Cited By ~ 1

Author(s):

Randhir S. Ranta ◽

Vijay Kumar Sharma ◽

Pankaj Gupta

Keyword(s):

Parenting Stress ◽

Assessment Scale ◽

Control Group ◽

Disabled Children ◽

Normal Children ◽

Need Assessment ◽

Significant Difference ◽

Group A ◽

And Control ◽

Experimental Group

The study pertains to the parenting stress, which is believed to be the resultant of child disability and further assesses the needs of the families across selected pockets of Himachal Himalaya. Perceived Stress Questionnaire (PSQ) and Need Assessment Scale were used for the purpose. For assessing the stress level among the parents, PQS was administered among two hundred parents having disabled children, herein called experimental group and two hundred parents with normal children, herein called control group. A three point Need assessment scale was used to measure the needs of 200 families on five different parameters. The result of t-test shows the significant difference between experimental and control groups indicating that the parents of disabled children experience more stress than their control counterpart. The study indicates that people need proper guidance and information regarding a child’s disability, nutritional requirements of a child, vocational training and child management. There is a need for proper counselling for parents suffering from stress and creating consciousness among parents of children with disabilities and in the society.

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Evaluation of oral conditions in patients with neurodegenerative diseases treated in geriatric centers

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720160001000022854 ◽

2016 ◽

Vol 64 (1) ◽

pp. 17-23

Author(s):

Bruna Marjorie Dias FROTA ◽

Sarah Nascimento HOLANDA ◽

Fabrício Bitú SOUSA ◽

Ana Paula Negreiros Nunes ALVES

Keyword(s):

Elderly Patients ◽

Neurodegenerative Diseases ◽

Oral Pathology ◽

Control Group ◽

Oral Manifestations ◽

Denture Stomatitis ◽

Exact Test ◽

Clinical Conditions ◽

Oral Conditions ◽

And Control

ABSTRACT Objective: To compare the general clinical conditions and oral alterations, and also evaluate the prosthesis, in subjects diagnosed with Alzheimer's disease (AD) or Parkinson's disease (PD), attended at two geriatric centers in the city of Fortaleza - Ceará. Methods: 70 patients were analyzed (between 57 to 91 years) with AD and PD, through evaluation of neurological medical records and oral clinical examination. Variables as sex, age, race, comorbidities, oral manifestations and prosthetic conditions were observed. A total of 20 elderly patients without neurological disease consisted the control group (CG). Fisher's exact test and Kruskal-Wallis were used as statistical analysis. Results: In both groups, blood hypertension was the most frequent comorbidity. As for the oral examination in the group with AD, it was observed that 54.2% had periodontal disease, 34.2% caries. Similar results were found in PD patients (31.4%; 22.8% - respectively). However, no difference was observed between the groups, as the systemic and oral manifestations in both geriatric centers (p> 0.05). Was identified more than half of the subjects (57.7%) using dentures, and 86.5% of these had become maladaptive, with some kind of defect. There was statistical difference in the presence of associated oral pathology, denture stomatitis, between dementia and control group (p = 0.0213). Conclusion: Elderly patients with AD and PD have poor oral health, as well as those without neurodegenerative diseases. However, have more defects and disorders associated with the use of removable dentures.

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NOSOGENIC DEPRESSION IN PATIENTS WITH PATHOLOGY OF THE MUCOUS ORAL CAVITY

The actual problems in dentistry ◽

10.18481/2077-7566-2019-15-4-50-54 ◽

2020 ◽

Vol 15 (4) ◽

pp. 50-54 ◽

Cited By ~ 2

Author(s):

Karen Karakov ◽

Tatyana Vlasova ◽

Artur Oganyan ◽

Araksia Khachaturyan ◽

Svetlana Karakova ◽

...

Keyword(s):

Comparative Analysis ◽

Oral Cavity ◽

Treatment Regimen ◽

Oral Mucosa ◽

New Technologies ◽

Well Being ◽

Diagnostic Methods ◽

Control Group ◽

Traditional Treatment ◽

And Control

Importance. Despite the improvement of diagnostic methods and the introduction of new technologies in the treatment of pathology of the oral mucosa, it is difficult to achieve stable remission, since 70 % of cases are based on somatic and bodily suffering factors. The article presents data from a comparative analysis of the use of the traditional treatment regimen for patients with pathology of the oral cavity and the inclusion of the latest generation of antipsychotics in the treatment regimen. It was established that, when applied, a tendency towards normalization of psychological and autonomic status was observed. The inclusion of anxiolytics and antioxidants in the complex of general therapy for patients with pathology of the oral mucosa contributed to a more pronounced positive dynamics of achieving and prolonging the phase of remission. Objectives — to evaluate the effectiveness of introducing drugs of the latest generation of antipsychotics into the traditional treatment regimen for patients with pathology of the oral cavity. Methodology. Under our supervision, there were 30 patients aged 40 to 60 years with a diagnosis of pathology of the oral mucosa and pathology of the periodontium. All examined were divided into 2 groups: the main (15 people) and control (15 people). Results. Clinical well-being, manifested in a subjective decrease in pain in the tongue, feelings of rawness, tingling, numbness, awkwardness, in the tongue, was noted already at the 5th visit in 67 % of patients of the main group, while in the control group in 17 % of patients. Conclusions. The inclusion of anxiolytics and antioxidants in the complex of general therapy for patients with pathology of the oral mucosa contributed to a more pronounced positive dynamics of achieving and prolonging the phase of remission. Our data allow us to implement this treatment regimen in practical healthcare.

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The Relationship between Smoking and Sublingual Varices in the Elderly

Oman Medical Journal ◽

10.5001/omj.2021.94 ◽

2021 ◽

Vol 36 (4) ◽

pp. e288-e288

Author(s):

Niusha Barzideh ◽

Arezoo Alaee ◽

Arash Azizi

Keyword(s):

Older Adults ◽

Cigarette Smoking ◽

Elderly Patients ◽

Varicose Veins ◽

The Elderly ◽

Control Group ◽

Case Group ◽

Chi Square ◽

Number Of Patients ◽

And Control

Objectives: We investigated the existence of any connection between smoking and sublingual varices (SLV) in the older population. Methods: This case-control study was conducted in 2019 on adults > 65 years old at Kahrizak Charity Nursing Home, Alborz, Iran. We conducted clinical examination and inspection of 222 elderly patients. Both the case group and control group contained the same number of patients (n = 111). SLV were classified as grade 0 (few or none visible) and grade 1 (moderate or severe). The case group included patients with SLV and the control group consisted of those older adults without SLV and who were matched with the case group based on age, gender, blood pressure, denture wearing, and varicose veins in their legs. Cigarette smoking habits were investigated in both groups. Smokers were considered those who smoked at least one cigarette per day for more than six months. Chi-square and odds ratio (OR) were used to statistically analyze the exposure of participants to smoking in both groups. Results: Among 222 participants, 21.6% and 5.4% were smokers in the case and control groups, respectively. The results of our data analysis revealed that SLV were significantly associated with smoking (p < 0.001, OR = 4). Conclusions: Elderly patients with SLV are more likely to be cigarette smokers. Therefore, cigarette smoking cessation programs are recommended for older adults in society.

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Urban nature as a response to stress of urban population

Glasnik Sumarskog fakulteta ◽

10.2298/gsf1715185v ◽

2017 ◽

pp. 185-198

Author(s):

Maja Vujcic ◽

Jelena Tomicevic-Dubljevic

Keyword(s):

Urban Population ◽

Positive Impact ◽

Well Being ◽

Mental Wellbeing ◽

Control Group ◽

Study Group ◽

Urban Nature ◽

Healthy Habits ◽

Response To Stress ◽

And Control

In everyday life, urban residents, especially the younger population, have given up some healthy habits of spending their free time outdoors in urban forests or parks. This study was conducted in order to understand how urban nature might help in reducing psychological stress and improving mental wellbeing. The participants were volunteer students of the Faculty of Forestry in Belgrade (n=47). These students were randomly recruited in the study and control group and self-tested using DASS 21 scale. The Arboretum of the Faculty of Forestry represented a research location and a special healing environment with a high variety of species. The study group stayed at the Arboretum during the study break period, while a control group was inside the Faculty. After the intervention, a slightly greater reduction in stress scale on the total score was recorded in the study group (F1.45 = 3.781; r < .058). This study has shown that urban green areas can have a positive impact on the mental well-being and reveal their role as a great response to the stress from urban population.

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The Effect of Psychodrama on Subjective Well-Being and Trait Anxiety

Journal of Educational Issues ◽

10.5296/jei.v6i2.17600 ◽

2020 ◽

Vol 6 (2) ◽

pp. 269

Author(s):

AliAyşe Nur Katmer ◽

Ramazan Demir ◽

Ali Çekiç ◽

Zeynep Hamamcı

Keyword(s):

Trait Anxiety ◽

Well Being ◽

Rank Test ◽

Control Group ◽

Subjective Well Being ◽

Control Groups ◽

Significant Difference ◽

Post Test ◽

And Control ◽

Experimental Group

This study investigates the effects of psychodrama on adults’ anxiety and subjective well-being levels. A pre/post-test experimental pattern is used with experimental and control groups. The study sample consists of 24 non-thesis master’s program students at Gaziantep University, Human Psychology, and Communication. The State-Trait Anxiety Inventory (STAI) and the Subjective Well-Being Scale were applied as a pre-test to the experimental and control groups. The psychodrama group practice was performed with the experimental group once a week for eleven weeks, 90 minutes per session, while the control group did not receive any practice. After the application, the post-test was administered to both groups. The data were analyzed with SPSS 23 statistical program. The Mann-Whitney U test was used to evaluate the difference between the experimental and control group, and the Wilcoxon Signed Rank Test was applied for the changes within the experimental group. The findings indicate that the individuals’ anxiety level in the experimental group significantly decreased compared to the control group. There was no significant difference between subjective well-being in the experimental and control group for pre-test and post-test applications.

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Impact of Islam-Based Caring Intervention on Spiritual Well-Being in Muslim Women with Breast Cancer Undergoing Chemotherapy

Religions ◽

10.3390/rel11070361 ◽

2020 ◽

Vol 11 (7) ◽

pp. 361

Author(s):

Maria Komariah ◽

Urai Hatthakit ◽

Nongnut Boonyoung

Keyword(s):

Breast Cancer ◽

Muslim Women ◽

Well Being ◽

Control Group ◽

Religion And Spirituality ◽

Peace Of Mind ◽

Chronic Illness Therapy ◽

Spiritual Well Being ◽

And Control ◽

The Impact

This research emphasizes the nurse’s role in incorporating Islamic teaching through the care practices provided in order to promote spiritual well-being in Muslim women with breast cancer undergoing chemotherapy. In addition, religion and spirituality have been recognized as the primary resources for coping. The aim of the study, therefore, was to explore the impact of an Islam-based caring intervention on the spiritual well-being of Muslim women with cancer. Furthermore, data were collected using a questionnaire and, also, the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp) on baseline (Time 1), days 3 (Time 2), 23 (Time 3), and 44 (Time 4). The results showed the significant impact of an Islam-based caring intervention on the participants’ level of spiritual well-being. In addition, the mean scores varied between the intervention and control group over time. Based on the reflection, participants stipulated feeling peace of mind, closer to God, spirit for further life, and healthier.

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VYC-25L Hyaluronic Acid Injectable Gel Is Safe and Effective for Long-Term Restoration and Creation of Volume of the Lower Face

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa013 ◽

2020 ◽

Vol 40 (9) ◽

pp. NP499-NP510 ◽

Cited By ~ 2

Author(s):

Patricia Ogilvie ◽

Laurence Benouaiche ◽

Wolfgang G Philipp-Dormston ◽

Lakhdar Belhaouari ◽

Frodo Gaymans ◽

...

Keyword(s):

Hyaluronic Acid ◽

Well Being ◽

Controlled Study ◽

Control Group ◽

Level Of Evidence ◽

Lower Face ◽

Repeat Treatment ◽

Acid Gel ◽

Surgical Treatments ◽

And Control

Abstract Background Juvéderm Volux (VYC-25L; Allergan plc) is an injectable hyaluronic acid gel designed to restore and create facial volume. Objective The aim of this study was to evaluate the safety and effectiveness of Volux for chin retrusion over 18 months and after repeat treatment. Methods This prospective, single-blind, controlled study enrolled subjects aged ≥18 years with chin retrusion (glabella-subnasale-pogonion facial angle 145°-165°). Subjects were randomized (3:1) to Volux at study onset or 3 months later (control group), and could receive a single repeat treatment during months 18 to 24. Assessments included mean facial-angle change from baseline, Global Aesthetic Improvement Scale (GAIS) responder rates (improved/much improved), improvements in 3 subject-reported FACE-Q scales, and safety. Results Of 132 enrolled subjects, 119 received initial Volux treatment and 89 received repeat treatment. Mean changes (95% confidence interval) in glabella-subnasale-pogonion angle from baseline for treatment and control groups, respectively, were: 1.15° (0.75°, 1.56°) and 1.16° (0.57°, 1.75°) at month 18, and 3.14° (2.68°, 3.61°) and 2.72° (1.78°, 3.66°) 1 month after repeat treatment. Investigators rated 52.5%/60.0% of treated/control subjects at month 18 and 96.9%/100% after retreatment as GAIS responders; subject-reported rates were 62.0%/64.0% and 93.8%/100%. Durable improvements in Satisfaction with Chin, Satisfaction with Lower Face and Jawline, and Psychological Well-Being were reported in 82.1%, 78.2%, and 60.3% of subjects, respectively, at month 18, and 92.3%, 93.8%, and 67.7% of subjects after retreatment. The safety profile was as expected. Conclusions Volux injectable gel is a safe, effective, and durable alternative to surgical treatments for increasing chin projection and jaw volume, and results in high patient satisfaction. Level of Evidence: 2

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Triazolam and Nitrazepam Use in Elderly Outpatients

Annals of Pharmacotherapy ◽

10.1177/106002809302700420 ◽

1993 ◽

Vol 27 (4) ◽

pp. 506-509 ◽

Cited By ~ 16

Author(s):

Naoko Takami ◽

Akira Okada

Keyword(s):

Elderly Patients ◽

Adverse Reactions ◽

Control Group ◽

Primary Reason ◽

Control Groups ◽

Telephone Interviews ◽

Elderly Outpatients ◽

Appropriate Therapy ◽

Study Participants ◽

And Control

OBJECTIVE: To determine adverse reactions and effects on sleep among three groups of patients: those taking triazolam, those taking nitrazepam, and a control group. DESIGN: Telephone interviews. PATIENTS: Forty-seven patients taking triazolam, 36 taking nitrazepam, and 40 control patients. All study participants were outpatients over 60 years of age. RESULTS: The rate of awakening in the middle of sleep was not significantly different among patients taking triazolam (61.7 percent) and those taking nitrazepam (69.4 percent). Incidence of nocturia, the primary reason for awakening, was not significantly different between triazolam- (36.2 percent) and nitrazepam-taking patients (41.7 percent). The rate of having difficulty falling back to sleep was significantly different among triazolam (62.1 percent) and nitrazepam (8 percent), and triazolam and control (11.1 percent) groups (p<0.01). No difference was evident, however, between nitrazepam and control groups. CONCLUSIONS: Patients taking nitrazepam have less difficulty returning to sleep compared with those who take triazolam. Thus, for elderly patients who awaken because of nocturia, nitrazepam may be more appropriate therapy.

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