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Personality and suicidal ideation in the elderly: factorial invariance and latent means structures across age
- Authors:
- ILICETO Paolo, et al
- Journal article citation:
- Aging and Mental Health, 18(6), 2014, pp.792-800.
- Publisher:
- Taylor and Francis
Objectives: Suicide among the elderly is a dramatic global health problem. Although fatal attempts are frequent in the elderly, research indicated that they rarely present long-term elaboration of suicidal ideation and communicate their intents. Consequently, risk factor detection and assessment are salient. Although evidence on the association between personality and suicidal ideation in young adults is accumulating, little is known about its relevance in the elderly. The purpose of the present study was to analyse the components of a measurement model that are invariant across young adults and older adults and then investigate the relations among dimensions of personality and suicide risk. The authors postulated a specific relation pattern a priori and tested the hypotheses statistically in order to examine the models for equivalency of the factorial measurement. Method: 316 young adults and 339 older adults, who were administered self-report questionnaires to assess depression, hopelessness, alternative five-factor model of personality, and self–other perception were investigated. Results: Multigroup confirmatory factor analyses were conducted, yielding a final model with excellent fit to the data. This model showed a similar pattern of associations between suicidal ideation and personality across both groups. Conclusions: Although the elderly are exposed to specific life stressors associated with suicidal ideation, the findings suggest that the elderly and young adults may be similar on personality and psychopathology variables predicting suicidal ideation than previously hypothesized. Implications are provided for enhanced assessment and intervention of the elderly high in neuroticism, depression, hopelessness, and with negative self–other perception. (Edited publisher abstract)
Factors associated with mental disorders in long-settled war refugees: refugees from the former Yugoslavia in Germany, Italy and the UK
- Authors:
- BOGIC Marija, et al
- Journal article citation:
- British Journal of Psychiatry, 200(3), March 2012, pp.216-223.
- Publisher:
- Cambridge University Press
This study examined whether the same sociodemographic characteristics, war experiences and post-migration stressors are associated with the same mental disorders in similar refugee groups (from the former Yugoslavia) resettled in Germany, Italy and the UK. A total of 854 war refugees were assessed (255 per country, mean age 42 years, 51% female). Prevalence rates of mental disorders varied substantially between the countries. A lower level of education, more war-related traumatic experiences, more migration-related stress, a temporary residence permit and not feeling accepted were independently associated with higher rates of mood and anxiety disorders. Mood disorders were also associated with older age, female gender and being unemployed, and anxiety disorders with the absence of combat experience. Higher rates of post-traumatic stress disorder (PTSD) were associated with older age, a lower level of education, more traumatic war experiences, absence of combat experience, more migration-related stress, and a temporary residence permit. Only younger age, male gender and not living with a partner were associated with substance use disorders. The associations did not differ significantly across the countries. War-related factors explained more variance in rates of PTSD, and post-migration factors in the rates of mood, anxiety and substance use disorder. The authors conclude that the risk factors vary for different disorders, but are consistent across host countries for the same disorders.
Poor mental and physical health differentially contributes to disability in hospitalized geriatric patients of different ages
- Authors:
- MARENGONI Alessandra, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(1), January 2004, pp.27-34.
- Publisher:
- Wiley
This article seeks to evaluate the relationship between depressive symptoms, cognition and somatic diseases on functional status of geriatric patients at hospital discharge. Patients 65+ years consecutively admitted to the acute care geriatric ward of the Internal Medicine Department I, Civil Hospital of Brescia, Italy, from February 1998 to December 2000 (n = 830) were examined. Functional disability was defined as need of physical assistance in at least one of the basic Activities of Daily Living (ADL). The Greenfield Index of Disease Severity (IDS) and the Geriatric Index of Comorbidity (GIC) were used to measure number and severity of diseases. The Mini-Mental State Examination (MMSE) assessed cognitive status and the Geriatric Depression Scale (GDS) measured depressive symptoms. Prevalence of functional disability at discharge was 29.3% in the younger age group (65-74 years) and 55.2% in the older age group (75+ years). Using logistic regression models, older age, poorer cognitive status, and depressive symptoms were independently associated with functional disability in the younger and older age group, respectively. Additionally cognitive impairment and depressive symptoms showed an additive association with disability, especially in younger patients, while comorbidity was correlated with functional status only in the oldest old, in particular among those who were cognitively impaired. Functional disability after acute hospitalization is highly prevalent in geriatric patients. Depressive symptoms, comorbidity, and cognitive impairment often coexist, interact and are differentially associated with function depending on age. Considering that depressive symptoms are a modifiable problem, their detection in hospital settings may help clinicians in targeting subjects at high risk of functional disability.
Integrating evaluative research and community-based mental health care in Verona, Italy
- Authors:
- TANSELLA Michele, BURTI Lorenzo
- Journal article citation:
- British Journal of Psychiatry, 183(8), August 2003, pp.167-169.
- Publisher:
- Cambridge University Press
The South Verona Psychiatric Case Register, covering the area served by the community-based mental health service monitors all contacts that South Verona adult residents have with in-patient services (including private psychiatric clinics and hospitals) and community mental health services. The Register and ad hoc surveys provide a basis for studies of service use and patterns of care over time. The following studies have been completed: longitudinal patterns of care; in-patient care prior and subsequent to the Italian psychiatric reform; long-stay and long-term patients; comparisons between South Verona services and other Italian and European services with a different system of care; exploring the relationship between population socio-demographic characteristics and service use; identification of the operational criteria of continuity of care; studies of mortality among psychiatric patients.
Mental health and deviance in inner cities
- Editors:
- PARRY-JONES William L.L., QUELOZ Nicolas
- Publisher:
- World Health Organization
- Publication year:
- 1991
- Pagination:
- 138p.,tables,bibliogs.
- Place of publication:
- Geneva
A collection of research papers, case-studies, and reviews by authors from a wide variety of agencies and organisations. Highlights issues for urgent consideration by governments and municipal authorities. Aims to provide starting points for future research and development of programmes for the care of vulnerable people in urban areas. Includes papers on: African cities; migrant acculturation and mental health; mentally ill offenders; and hospital and community psychiatric care in Italian cities.
Predictors of comprehensive stimulation program efficacy in patients with cognitive impairment. Clinical practice recommendations
- Authors:
- BINETTI Giuliano, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(1), 2013, pp.26-33.
- Publisher:
- Wiley
This longitudinal study examined which factors best predict response to a comprehensive stimulation programme offered to patients with dementia and mild cognitive impairment (MCI) and their caregivers. A total of 145 Italian patients (55 with MCI and 90 with dementia), participating to a cognitive motor rehabilitation program, and their 131 caregivers, attending informational/psychoeducational interventions were followed for six months. Three alternative cognitive stimulation interventions were used: Reality Orientation Therapy, Global Reactivation Therapy, and Memory Training. Mini mental state examination, Alzheimer’s Disease Assessment Scale-Cognition, and Clinician’s Interview-Based Impression of Change-plus were the primary outcome measures. Sixty-eight (46.9%) of the 145 subjects were classified as clinical responders. At baseline, responders had a significantly less insight into impairment, greater functional capacity as well as fewer delusions, euphoria, and aberrant motor behaviours than the non-responder. After 6 months, along with an improvement in cognition, responders also showed decreased behavioural disturbances and severity of disturbances. During the analysis the caregiver's burden of distress remained stable; however after 6 months the burden of the caregivers of MCI responders was reduced. The authors conclude that a high level of insight, preserved functional abilities as well as the lack of severe delusions, euphoria, and aberrant motor behaviours are significant predictors of responsiveness to stimulation programmes.
Psychological abuse among older persons in Europe: a cross-sectional study
- Authors:
- MACASSA Gloria, et al
- Journal article citation:
- Journal of Aggression Conflict and Peace Research, 5(1), 2013, pp.16-34.
- Publisher:
- Emerald
There is evidence to suggest that the rate of elder abuse in all its forms is growing. However, because of the difficulty of measuring it, psychological abuse may be underestimated. This cross sectional study used data collected in 2009 as part of the survey “Elder abuse: a multinational prevalence survey, ABUEL”. The participants were 4,467 randomly selected persons aged 60-84 years (2,559 women, 57.3 per cent) from seven EU countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, Sweden). Participants answered a structured questionnaire either face-to-face or a mix of interview/self-response. The overall prevalence of psychological abuse was 29.7 per cent in Sweden, 27.1 per cent in Germany; 24.6 per cent in Lithuania and 21.9 per cent in Portugal. The lowest prevalence was reported in Greece, Spain and Italy with 13.2 per cent, 11.5 per cent and 10.4 per cent, respectively. Similar tendencies were observed concerning minor/severe abuse. The Northern countries (Germany, Lithuania, Sweden) compared to Southern countries (Greece, Italy, Portugal, Spain) reported a higher mean prevalence of minor/severe abuse (26.3 per cent/11.5 per cent and 12.9 per cent/5.9 per cent, respectively). Most perpetrators (71.2 per cent) were spouses/partners and other relatives (e.g. children). The analyses indicate that being from Greece, Italy, Portugal and Spain was associated with a lower risk of psychological abuse. Low social support, living in rented housing, alcohol use, frequent health care use, and high scores in anxiety and somatic complaints were associated with increased risk of psychological abuse.
Open trial on crisis psychotherapy in Padova, Italy
- Authors:
- PAVAN I., et al
- Journal article citation:
- Brief Treatment and Crisis Intervention, 3(1), Spring 2003, pp.37-46.
- Publisher:
- Oxford University Press
Crisis psychotherapy is addressed to patients with feelings of impotence: a precise psychological correlate characteristic of the crisis situation. Associated with this picture are anxious-depressive and personality disorders. Prevention focuses on recovering previous level of functioning in order to forestall the evolution of maladaptive behaviors that may in turn lead to chronic pathology or suicide. The aim of this study was to preliminarily assess symptom outcome in 42 cases treated with the model adopted in Padua, Italy. Assessment was based on various instruments to explore depression (Beck Depression Inventory [BDI], Hamilton Depression Rating Scale [HRSD]), anxiety (State-Trait Anxiety Expression Inventory [STAI]), anger (State-Trait Anger Expression Inventory [STAXI]), global functioning (Global Assessment Scale [GAS]), social adjustment (Social Adaption Self Evaluation Scale [SASS]), stressful events, and personality (Structured Clinical Interview for DSM-IV [SCID II]). Depression and anxiety levels displayed a significant decrease at the end of treatment. There was also a significant reduction in levels of trait anxiety and anger, probably indicating a "return to baseline" after a destabilizing experience. These effects mark a "traumatic" impasse resulting from stressful life events that may be either real external events or subjectively traumatic psychological events. Other positive effects of the therapy were improvement in global functioning and renewed interest in social relations. Some degree of comorbidity with personality disorders emerged, especially from DSM-IV clusters C and B. Further controlled studies are warranted to assess the effect of spontaneous remission on this intervention technique.
Removing children from the care of adults with diagnosed mental illnesses - a clash of human rights?
- Author:
- PRIOR Pauline
- Journal article citation:
- European Journal of Social Work, 6(2), 2003, pp.179-190.
- Publisher:
- Taylor and Francis
Health and social services providers throughout Europe are increasingly aware of the possibility of litigation from service users arising from the application of a human rights perspective to public service provision. Presents an analysis of ECHR cases related to breaches of human rights that occurred when children were taken into care from families in which one or both parents had a diagnosed mental illness. The issues raised by these cases include the following: how to ensure that the right to family life is protected for adults with mental illnesses: how to ensure access and opportunities for parents to continue bonding with children in care; and how to avoid damaging children while giving time for a proper assessment of the care situation.
Caring for mentally ill people in Europe
- Authors:
- VAN OS Jan, NEELEMAN Jan
- Journal article citation:
- British Medical Journal, 5.11.94, 1994, pp.1218-1221.
- Publisher:
- British Medical Association
Despite legislation to harmonise mental health practice throughout Europe and convergence in systems of training there remains an extraordinary diversity of psychiatric practice in Europe. Approaches to tackling substance misuse vary among nations; statistics on psychiatric morbidity are affected by different approaches to diagnosis and treatment of psychiatric disorders; attitudes towards mental illness show definite international differences. Everywhere, though, mental health care for patients with psychotic illness is a "cinderella service", and there is a general move towards care falling increasingly on the family and the community.