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Prevalence of depression in older patients consulting their general practitioner in the Netherlands
- Authors:
- LICHT-STRUNK Els, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(11), November 2005, pp.1013-1019.
- Publisher:
- Wiley
Data of The West Friesland Study were used. Five thousand, six hundred and eight-six GP attendees of 55 years and older filled in the Geriatric Depression Scale - 15 items as a screening instrument for depression (response 62%). Of those screened positive on the GDS-15, 846 (77.5%) were interviewed using the Primary Care Evaluation of Mental Disorders (PRIME-MD). A random sample of 102 patients scoring below the threshold of the GDS-15 was interviewed to estimate the proportion of false negatives. Major depression was prevalent in 13.7% and minor depression in 10.2% of the patients. Depressed patients were older, more often female and lived more often in urban districts. Patients with major depression were younger and more often female than those with a minor depression. Only 22.9% of the patients with a major depression were treated with antidepressants. Depression in older GP attendees is a very common health problem. Further research should focus on identifying those groups of patients with high risk of persistence of depression. This could help to focus the limited resources available in general practice to those patients in whom treatment is most urgently needed.
Effect of psychiatric disorders on outcome of cognitive-behavioural therapy for chronic fatigue syndrome
- Authors:
- PRINS Judith, et al
- Journal article citation:
- British Journal of Psychiatry, 187(2), August 2005, pp.184-185.
- Publisher:
- Cambridge University Press
Psychiatric disorders have been associated with poor outcome in individuals with chronic fatigue syndrome (CFS). This Dutch study examines the impact of psychiatric disorders on outcome of cognitive-behavioural therapy (CBT). Psychiatric diagnoses were assessed with a structured psychiatric interview in a CBT trial of 270 people with CFS. Lifetime and current psychiatric disorders were found in 50 and 32% respectively. No significant differences in fatigue severity and functional impairment following treatment were found between participants with and without psychiatric diagnoses.
The workload of GPs: consultations of patients with psychological and somatic problems compared
- Authors:
- ZANTINGE Else M., et al
- Journal article citation:
- British Journal of General Practice, 55(517), August 2005, pp.609-614.
- Publisher:
- Royal College of General Practitioners
A cross-sectional national survey was carried out in 104 general practices in the Netherlands. 1392 Videotaped consultations of a representative sample of 142 GPs were used. Consultations were categorised into groups. Results found that consultations in which patients' mental health problems play a part (as a diagnosis or in the background) take more time involve more diagnoses, and the GP is more heavily burdened with feeling of insufficiency of patient time. In consultations with somatic diagnosis but psychological background, GPs more often experienced a lack of time compared to consultations with a psychological or social diagnosis.
Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study
- Authors:
- MOL Saskia S. L., et al
- Journal article citation:
- British Journal of Psychiatry, 186(6), June 2005, pp.494-499.
- Publisher:
- Cambridge University Press
Post-traumatic stress disorder (PTSD) is the only psychiatric condition that requires a specific event to have occurred for its diagnosis. The aim was to gather evidence from the adult general population on whether life events (e.g. divorce, unemployment) generate as many symptoms of post-traumatic stress as traumatic events (e.g. accidents, abuse). Data on demographic characteristics and history of stressful events were collected through a written questionnaire sent to a random sample of 2997 adults. Respondents also filled out a PTSD symptom checklist, keeping in mind their worst event. Mean PTSD scores were compared, controlling for differences between the two groups. Differences in item scores and in the distribution of the total PTSD scores were analysed. Of the 1498 respondents, 832 were eligible for inclusion in our analysis. For events from the past 30 years the PTSD scores were higher after life events than after traumatic events; for earlier events the scores were the same for both types of events. These findings could not be explained by differences in demographics, history of stressful events, individual item scores, or the distribution of the total PTSD scores. Life events can generate at least as many PTSD symptoms as traumatic events. Our findings call for further studies on the specificity of traumatic events as a cause of PTSD.
Impact of a foot and mouth disease crisis on post-traumatic stress symptoms in farmers
- Authors:
- OLFF Miranda, et al
- Journal article citation:
- British Journal of Psychiatry, 186(2), February 2005, pp.165-166.
- Publisher:
- Cambridge University Press
Culling 27 000 farm animals during an epidemic of foot and mouth disease in The Netherlands in 2001 resulted in substantial psychological distress among Dutch farmers. We investigated the association of exposure to this crisis with symptoms of intrusions and avoidance as found in post-traumatic stress disorder. Survey results from the Impact of Event Scale administered to 661 Dutch dairy farmers showed that about half of those whose animals were culled suffered from severe post-traumatic distress. The authors conclude that such agricultural crises can have a substantial impact on mental health.
The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial
- Authors:
- FINNEMA Evelyn, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(4), April 2005, pp.330-343.
- Publisher:
- Wiley
The aim was to examine the effect of integrated emotion-oriented care on nursing home residents with dementia and nursing assistants. A multi-site randomized clinical trial with matched groups was performed, and measurements taken at baseline and after seven months. Sixteen psychogeriatric wards in fourteen nursing homes in the Netherlands were examined. One hundred and forty-six elderly residents with the diagnosis dementia of the Alzheimer (DAT) type, mixed DAT and vascular dementia, and dementia syndrome (NAO) and 99 nursing assistants participated. The following measurements were used. Demented elderly: Behaviour and mood related to adaptation to the illness and the institutionalization. Nursing assistants: General health as measured by feelings of stress, stress reactions, feeling of competence and illness. Positive effects in favour of the integrated emotion-oriented care were found in mild to moderately demented residents on two adaptive tasks: maintaining an emotional balance (less anxiety) and preserving a positive self-image (less dissatisfaction). In the trained group of nursing assistants fewer stress reactions were found only in those who perceived improvement in their emotion-oriented care skills after training. Emotion-oriented care is more effective with regard to the emotional adaptation in nursing homes of persons with a mild to moderate dementia. For the severely demented elderly we did not find this surplus value. This outcome is of clinical importance for elderly persons with dementia who are cared for in nursing homes. With respect to the nursing assistants it is concluded that emotion-oriented care has a positive influence on stress reactions in some of them.