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.
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.
Subject terms:
mental health problems, older people, problem solving, psychiatry, primary care, risk, acute psychiatric care, cognitive impairment, depression, diagnosis;
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.
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.
Subject terms:
mental health problems, mental health services, outcomes, psychiatry, social care provision, community mental health services, communication, financing;
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.
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.
Subject terms:
law, mental health, mental health problems, mental health services, psychiatry, social care provision, treatment, therapy and treatment, training, attitudes, community care, diagnosis, families;
Scotland. Scottish Executive. Central Research Unit
Publication year:
2000
Pagination:
125p.,bibliog.
Place of publication:
Edinburgh
Aims to provide a summary of current and recent UK and international literature on the sentencing of dangerous offenders and the subsequent management of these offenders, whether in hospital or prison settings, and upon release into the community. The research is divided by country, split up into those who use a community protection approach, those who use a clinical approach, and other jurisdictions. It concludes with an examination of the issue of compliance with the European Convention on Human Rights.
Aims to provide a summary of current and recent UK and international literature on the sentencing of dangerous offenders and the subsequent management of these offenders, whether in hospital or prison settings, and upon release into the community. The research is divided by country, split up into those who use a community protection approach, those who use a clinical approach, and other jurisdictions. It concludes with an examination of the issue of compliance with the European Convention on Human Rights.
Subject terms:
hospitals, human rights, law, law courts, legal proceedings, mental health problems, offenders, psychiatry, prisons, rape, sentences, sex offenders, sexual offences, treatment, therapy and treatment, violence, dangerous offenders, crime, criminal justice;
Location(s):
Canada, Australia, Belgium, Denmark, England, Hungary, Iceland, Finland, France, Italy, Germany, Netherlands, New Zealand, Norway, Poland, Switzerland, Scotland, Spain, United States, Wales