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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.
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.