International Journal of Geriatric Psychiatry, 26(8), August 2011, pp.833-842.
Publisher:
Wiley
... the PEP in 12 group sessions for 3 months, whereas the control group had usual care. Patients in both groups were diagnosed and treated with pharmacotherapy. Patients' primary efficacy variable was functional status assessed with the Disability Assessment Scale for Dementia scale. Carers’ outcome measure was depressive symptoms assessed with the Montgomery and Asberg Depression Rating Scale. Assessment
The “Aide dans la Maladie d'Alzheimer” study examined whether a psycho-educational programme (PEP) for primary carers in addition to standard anti-dementia drugs for patients improves carers’ psychological condition and patients' activities of daily life. Participants included 167 patient-carers dyads from 15 French memory clinics and randomised in two groups. The intervention group was offered the PEP in 12 group sessions for 3 months, whereas the control group had usual care. Patients in both groups were diagnosed and treated with pharmacotherapy. Patients' primary efficacy variable was functional status assessed with the Disability Assessment Scale for Dementia scale. Carers’ outcome measure was depressive symptoms assessed with the Montgomery and Asberg Depression Rating Scale. Assessment was done at baseline, 3 and 6 months. Patients' stabilisation was observed in both groups. For carers, significant improvement in disease understanding at 3 and 6 months, and in ability to cope with care-recipients' disease at 6 months was evidenced. The authors concluded that while the PEP improved carers’ condition, it was not sufficient to improve patients' activities in daily life.
International Journal of Geriatric Psychiatry, 26(8), August 2011, pp.853-859.
Publisher:
Wiley
Symptoms of depression are often missed in older nursing home residents because they may be dismissed as an inevitable consequence of ageing. This paper describes the construction of an instrument (NH-SDI) to detect depression in older nursing home residents. Three hundred and twenty eight older people were selected at random from 17 nursing homes in France, and examined by a single investigator. for a cut-off score above 5. The authors concluded that the NH-SDI appeared to be a useful instrument for the detection of depression in nursing homes and could easily be used by staff as part of routine procedures.
Symptoms of depression are often missed in older nursing home residents because they may be dismissed as an inevitable consequence of ageing. This paper describes the construction of an instrument (NH-SDI) to detect depression in older nursing home residents. Three hundred and twenty eight older people were selected at random from 17 nursing homes in France, and examined by a single investigator. The examination included a psychiatric assessment, an evaluation of cognitive function, an evaluation of depressive state using four different instruments, and assessment of any changes in behaviour in those suffering from dementia. A scale of 16 dichotomous items (NH-SDI) was created. The internal consistency was satisfactory, as was its reliability with a sensitivity of 85% and a specificity of 87% for a cut-off score above 5. The authors concluded that the NH-SDI appeared to be a useful instrument for the detection of depression in nursing homes and could easily be used by staff as part of routine procedures.
Aging and Mental Health, 12(3), May 2008, pp.310-316.
Publisher:
Taylor and Francis
The associations of frequency of performing three types of socially productive activities (voluntary work, informal help and caring for a person) were tested with depressive symptoms in older people. Data on social activities and frequency of performance were collected in the frame of the annual follow-up of the French GAZEL cohort study in 2005. Depressive symptoms were measured by the CES-D scale. Perceived control was assessed by two items of a quality of life measure (CASP-19). Total of 14,477 respondents aged 52-66 years completed a standardized questionnaire. Linear regression models were calculated adjusting for important confounders including self-rated health assessed during the previous year. In activities characterized by high autonomy (in particular voluntary work) a negative association of frequency with depressive symptoms was observed, whereas the reverse effect was found in the type of activity with low autonomy (care for a person). Perceived control mediated in part the association of frequency of activity with depressive symptoms. It is concluded that being often socially productive in early old age may contribute to well-being to the extent that autonomy and perceived control are given.
The associations of frequency of performing three types of socially productive activities (voluntary work, informal help and caring for a person) were tested with depressive symptoms in older people. Data on social activities and frequency of performance were collected in the frame of the annual follow-up of the French GAZEL cohort study in 2005. Depressive symptoms were measured by the CES-D scale. Perceived control was assessed by two items of a quality of life measure (CASP-19). Total of 14,477 respondents aged 52-66 years completed a standardized questionnaire. Linear regression models were calculated adjusting for important confounders including self-rated health assessed during the previous year. In activities characterized by high autonomy (in particular voluntary work) a negative association of frequency with depressive symptoms was observed, whereas the reverse effect was found in the type of activity with low autonomy (care for a person). Perceived control mediated in part the association of frequency of activity with depressive symptoms. It is concluded that being often socially productive in early old age may contribute to well-being to the extent that autonomy and perceived control are given.
International Journal of Geriatric Psychiatry, 23(3), March 2008, pp.324-330.
Publisher:
Wiley
... depressive symptoms (HDS) and 33.6% of in those with current major depressive disorder (MDD). The factors associated with antidepressant use varied according to depression status. In particular, men with current MDD were more often treated with antidepressants than women whereas, in both the HDS and the non-depressed groups, antidepressant use was, as has been observed elsewhere, more frequent in women. Gender also had a strong modifying effect on the relationship between antidepressant use and history of major depression. Finally, the direction of the association between antidepressant use and cognitive performance varied according to depression status. This study showed that the direction and strength of the association between antidepressant use and demographic and health-related factors varied according to the severity of depression symptoms. Further studies are needed to clarify the relationship between gender and cognition and antidepressant use.
The aim of this study was to identify factors associated with antidepressant use in non-depressed and depressed elderly persons, assuming that they varied according to clinical status. The authors studied 7,868 French community-dwelling subjects aged 65 years and over. The Center for Epidemiological Studies-Depression scale and the Mini International Neuropsychiatric Interview were used to define three groups: non-depressed, high depressive symptoms and current major depressive disorder. Separate analyses were performed to identify the factors which were associated with antidepressant use in each group. Antidepressant use (55% selective serotonin re-uptake inhibitors, 25% tricyclic antidepressants, 20% other types) increased from 4.9% in non-depressed subjects to 17.3% in subjects with high depressive symptoms (HDS) and 33.6% of in those with current major depressive disorder (MDD). The factors associated with antidepressant use varied according to depression status. In particular, men with current MDD were more often treated with antidepressants than women whereas, in both the HDS and the non-depressed groups, antidepressant use was, as has been observed elsewhere, more frequent in women. Gender also had a strong modifying effect on the relationship between antidepressant use and history of major depression. Finally, the direction of the association between antidepressant use and cognitive performance varied according to depression status. This study showed that the direction and strength of the association between antidepressant use and demographic and health-related factors varied according to the severity of depression symptoms. Further studies are needed to clarify the relationship between gender and cognition and antidepressant use.
Journal of Adolescence, 30(4), August 2007, pp.587-600.
Publisher:
Academic Press
The aim of the study was to evaluate the link between the different dimensions of depressive symptoms and suicidal ideation in adolescents. A sample of 1057 adolescents completed the CES-D (Center for Epidemiological Studies Depression Scale) and three additional items measuring suicidal ideation. The four dimensions of depressive symptoms on the CES-D (Depressed Affect, Loss of Positive Affect,
The aim of the study was to evaluate the link between the different dimensions of depressive symptoms and suicidal ideation in adolescents. A sample of 1057 adolescents completed the CES-D (Center for Epidemiological Studies Depression Scale) and three additional items measuring suicidal ideation. The four dimensions of depressive symptoms on the CES-D (Depressed Affect, Loss of Positive Affect, Somatic and Retarded Activity, Interpersonal) were entered into regression analyses predicting the presence of any suicidal ideation and of the wish to kill oneself among participants with moderate/severe depressive symptoms (n=271). For both boys and girls Depressed Affect was the main significant predictor of the presence of any suicidal ideation and of the wish to kill oneself. There were two additional significant predictors for boys: Loss of Positive Affect positively predicted the presence of any suicidal ideation; Somatic and Retarded Activity negatively predicted the presence of the wish to kill oneself.
Subject terms:
students, suicide, young people, adolescence, depression;
International Journal of Geriatric Psychiatry, 21(11), November 2006, pp.1052-1059.
Publisher:
Wiley
... history of psychiatric illness other than depression, memory disorders and one previous suicide attempt. The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression. Elderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which
The authors made a descriptive survey to assess the outcome of elderly patients discharged from a hospital psychiatric service after a suicide attempt (rates of overall mortality and repeat attempts), to identify the factors that had a significant impact on their survival and to determine patient characteristics. Fifty-nine suicide attempters over 60 years of age admitted to hospital between 1993 and 2000 were included in the study. Their outcome was assessed by questioning their attending physicians over the telephone. We traced 51 of the 59 patients; 8 were lost to follow-up. Statistical analysis (Log Rank tests, Cox model) was computed to determine which factors altered the overall survival and the survival without further attempt. The patients sociodemographic, medical and psychiatric characteristics were recorded from hospital patient files. Elderly suicide attempters showed an increased mortality from suicide and natural causes and the risk of a repeat attempt increased in female patients with memory disorders. The factors altering survival were advanced age, pre-existing physical disability, several co-existing physical illnesses, severe physical consequences of the suicide attempt, history of psychiatric illness other than depression, memory disorders and one previous suicide attempt. The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression. Elderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which it is essential to detect.
International Journal of Geriatric Psychiatry, 21(10), October 2006, pp.924-929.
Publisher:
Wiley
Amnestic mild cognitive impairment (aMCI) involves episodic memory. The person who presents aMCI has a high risk of developing Alzheimer's disease (AD). However, prediction of deterioration to dementia in cases of aMCI can be confounded with depression due to lack of specificity on selective memory tests. Finding a test sensitive to aMCI but not to depression would be potentially most useful to subsequent longitudinal studies researching the neuropsychological markers of preclinical AD. We hypothesized that the performance on a topographical memory task would be sensitive to the aMCI condition, while depression would not influence such a performance. A group of 137 community-dwelling French-speaking subjects between 55 and 70 years old was administered a topographical recognition memory task. Based on aMCI and depression criteria, 45 subjects were selected and divided into four groups: 11 patients with aMCI without depression, nine depressive patients with aMCI, ten depressive patients without cognitive impairment and 15 control subjects. The remaining non-selected participants did not belong to any of the previous interest groups. The aMCI factor had a significant effect on the topographical recognition memory task scores, while the depression factor did not. The aMCI patients performed worse than the non-aMCI. Although these results were found with relatively small groups, deficits in topographical recognition memory were observed in aMCI patients and did not seem to be sensitive to depression. Further longitudinal studies are needed to examine whether deficits in topographical
Amnestic mild cognitive impairment (aMCI) involves episodic memory. The person who presents aMCI has a high risk of developing Alzheimer's disease (AD). However, prediction of deterioration to dementia in cases of aMCI can be confounded with depression due to lack of specificity on selective memory tests. Finding a test sensitive to aMCI but not to depression would be potentially most useful to subsequent longitudinal studies researching the neuropsychological markers of preclinical AD. We hypothesized that the performance on a topographical memory task would be sensitive to the aMCI condition, while depression would not influence such a performance. A group of 137 community-dwelling French-speaking subjects between 55 and 70 years old was administered a topographical recognition memory task. Based on aMCI and depression criteria, 45 subjects were selected and divided into four groups: 11 patients with aMCI without depression, nine depressive patients with aMCI, ten depressive patients without cognitive impairment and 15 control subjects. The remaining non-selected participants did not belong to any of the previous interest groups. The aMCI factor had a significant effect on the topographical recognition memory task scores, while the depression factor did not. The aMCI patients performed worse than the non-aMCI. Although these results were found with relatively small groups, deficits in topographical recognition memory were observed in aMCI patients and did not seem to be sensitive to depression. Further longitudinal studies are needed to examine whether deficits in topographical recognition memory are a neuropsychological marker of preclinical AD.
International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.471-478.
Publisher:
Wiley
Although depression is known to be frequently associated with dementia, it is nonetheless under-diagnosed and under-treated among this patient population. Its effect on outcome for dementia patients is thought to be substantial, because depression appears to induce higher than normal rates of disability as well as supplementary cognitive decline. The aim of this study was to measure the impact of major depression on the institutionalization rate of community-dwelling dementia patients. Three-hundred forty-eight consecutive dementia outpatients of a geriatric clinic (mean age: 81 years, 69.8% women, 65.5% dementia of Alzheimer's type, mean baseline MMSE score: 20.5), followed between 1997 and 2002 (mean follow-up: 20.5 months). Twenty-five percent of the patients met the criteria of major depression at baseline, and only 30.3% of these received antidepressant medication. Major depression at baseline was independently associated with nursing home admission within one year of the baseline assessment. Antidepressant medication tended to protect against this outcome, but not to a statistically significant extent. Major depression at baseline is an independent risk factor for early institutionalization of dementia sufferers. Early institutionalization is defined in this study as nursing home placement within a year of diagnosis with dementia at our specialized outpatient center. The study highlights the need for better management of depression among dementia outpatients. Further investigation is needed to evaluate the protective effect of antidepressant medication (and/or non-pharmacological
Although depression is known to be frequently associated with dementia, it is nonetheless under-diagnosed and under-treated among this patient population. Its effect on outcome for dementia patients is thought to be substantial, because depression appears to induce higher than normal rates of disability as well as supplementary cognitive decline. The aim of this study was to measure the impact of major depression on the institutionalization rate of community-dwelling dementia patients. Three-hundred forty-eight consecutive dementia outpatients of a geriatric clinic (mean age: 81 years, 69.8% women, 65.5% dementia of Alzheimer's type, mean baseline MMSE score: 20.5), followed between 1997 and 2002 (mean follow-up: 20.5 months). Twenty-five percent of the patients met the criteria of major depression at baseline, and only 30.3% of these received antidepressant medication. Major depression at baseline was independently associated with nursing home admission within one year of the baseline assessment. Antidepressant medication tended to protect against this outcome, but not to a statistically significant extent. Major depression at baseline is an independent risk factor for early institutionalization of dementia sufferers. Early institutionalization is defined in this study as nursing home placement within a year of diagnosis with dementia at our specialized outpatient center. The study highlights the need for better management of depression among dementia outpatients. Further investigation is needed to evaluate the protective effect of antidepressant medication (and/or non-pharmacological therapies) on the institutionalization rate.
British Journal of Psychiatry, 181, August 2002, pp.111-116.
Publisher:
Cambridge University Press
... with a 3 year follow up. Results found that in both genders, high job demands and low social support at work were predictive of increased Depression scale scores, irrespective of personality traits.
This French study examines the relationship between psychosocial factors at work and changes in depressive symptoms, taking personality traits into account. The role of occupational characteristics, psychosocial stress and personality traits in predicting an increase of depressive symptoms was evaluated in a large sample of men and women working at a French National Electric and Gas Company, with a 3 year follow up. Results found that in both genders, high job demands and low social support at work were predictive of increased Depression scale scores, irrespective of personality traits.
Subject terms:
personality, social networks, stress, depression, employment;
Aging and Mental Health, 16(4), May 2012, pp.431-437.
Publisher:
Taylor and Francis
... (FGA). The aim of this study was to examine the relationships between negative life events and TGP and FGA in elderly people, and their effects on mental health. The participants were 670 community-dwelling elderly people who completed measures of TGP, FGA, negative life events and depression. Analyses of the findings demonstrate the role of TGP and FGA in coping with negative life events. While both FGA and TGP were related to depression, FGA was found to have beneficial effects for the participants who had encountered negative life events. With age, people become less tenacious, but no conclusive relationship was found between flexibility and age. The findings support the importance of both modes of coping for the mental health of older adults. In particular, the ability to adjust goals
This paper considers the question of how older adults cope with negative life events. It draws on a model suggested by Brandtstädter which addresses the dynamics of goal striving throughout the life span, allowing a clearer understanding of how people adapt as they get older. The model postulates 2 fundamental modes of self-regulation: tenacious goal pursuit (TGP) and flexible goal adjustment (FGA). The aim of this study was to examine the relationships between negative life events and TGP and FGA in elderly people, and their effects on mental health. The participants were 670 community-dwelling elderly people who completed measures of TGP, FGA, negative life events and depression. Analyses of the findings demonstrate the role of TGP and FGA in coping with negative life events. While both FGA and TGP were related to depression, FGA was found to have beneficial effects for the participants who had encountered negative life events. With age, people become less tenacious, but no conclusive relationship was found between flexibility and age. The findings support the importance of both modes of coping for the mental health of older adults. In particular, the ability to adjust goals is shown to be critical as a way of preventing the development of depressive symptoms following negative life events.
Subject terms:
life events, models, objectives setting, older people, coping behaviour, depression;