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Anxiety among older psychiatric patients: a hidden comorbidity?
- Authors:
- BENDIXEN Anette Bakkane, ENGEDAL Knut
- Journal article citation:
- Aging and Mental Health, 20(11), 2016, pp.131-1138.
- Publisher:
- Taylor and Francis
Objectives: The authors' aims were to explore prevalence of anxiety among patients admitted to departments of geriatric psychiatry for treatment of various diagnoses and to examine how often anxiety was registered as a previous or ongoing diagnosis. Method: In all, 473 patients admitted to one of five departments of geriatric psychiatry were included in a quality register and examined according to a standardised protocol. The Geriatric Anxiety Inventory (GAI) was used to measure anxiety during the first week after admission. Diagnoses were made at discharge. Results: Using a cutoff on the GAI of 8/9, the prevalence of anxiety for the following diagnostic groups was depression 65.3%, psychosis 28%, dementia 38.8% and mania 33.3%. Of 24 patients with a primary diagnosis of anxiety, 66.7% scored above 8 on the GAI. Of 236 patients with a GAI score above 8, only 22 (9.3%) were reported to have a comorbid anxiety disorder by the treating psychiatrist. In a multiple regression analysis, we found that the severity of depression (beta 0.585, p < 0.001), being female (beta 0.096, p 0.028) and the use of antipsychotic drugs (beta 0.129, p 0.006) and anxiolytic drugs (beta 0.129, p 0.005) were associated with a higher GAI score. Conclusion: Anxiety is common in geriatric psychiatric patients, regardless of the primary diagnosis. The findings suggest that anxiety is often a hidden comorbidity in various psychiatric disorders. A high score on the GAI was associated with the severity of depression, female gender and the use of antipsychotic and anxiolytic drugs. (Edited publisher abstract)
Depression in Alzheimer's disease: specificity of depressive symptoms using three different clinical criteria
- Authors:
- ENGEDAL Knut, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(9), September 2011, pp.944-951.
- Publisher:
- Wiley
It is not clear whether symptoms of depression in Alzheimer's disease patients differ from those seen in other elderly depressed patients. This study aimed to examine the usefulness of the specific criteria for depression in Alzheimer's disease which have been developed, the Provisional Diagnostic Criteria for Depression in Alzheimer's Disease (PDC-dAD), compared to other existing depression criteria. The study used 112 patients with Alzheimer's disease recruited from 2 hospitals of geriatric psychiatry in Norway. The patients were interviewed by a psychiatrist who diagnosed depression according to a range of scales, and were assessed by trained nurses who also interviewed their caregivers. The researchers found that the most prominent and significant symptoms of depression in patients with Alzheimer's disease are the same symptoms that are considered the core symptoms of depression in older people who do not suffer from dementia. They report that using the PDC-dAD, more patients received a diagnosis of depression than when using other existing depression criteria, and discuss the results and their implications.
High score on the Relative Stress Scale, a marker of possible psychiatric disorder in family carers of patients with dementia
- Authors:
- ULSTEIN Ingun, WYLLER Torgier, ENGEDAL Knut
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(3), March 2007, pp.195-202.
- Publisher:
- Wiley
Compares the scores on the Relative Stress Scale (RSS) with those on the General Health Questionnaire (GHQ) and the Geriatric Depression Scale (GDS), and to establish a cut-off score for RSS in order to distinguish carers with symptoms of psychiatric disorders from those without. One hundred and ninety-four carers of 194 patients suffering from dementia according to ICD-10 were included in the study. Burden of care was assessed by the 15-items RSS, and psychiatric symptoms by means of the GHQ-30 and the 30-items GDS. A case score above 5 on GHQ and above 13 on GDS were used to define carers with probable psychiatric morbidity. Sensitivity (SS), specificity (SP), accuracy and likelihood ratio for a positive test (LR+) were calculated for different cut-points of the RSS. Fifty-six percent of the carers had a GHQ score above 5, and 22% had a GDS score above 13. A two-step cluster analysis using 192 of the 194 carers, identified three groups of carers; a low risk group for psychiatric morbidity (LRG), 82 carers with GHQ 5 and GDS 13; a medium risk group (MRG), 69 carers with GHQ > 5 and GDS 13; and a high-risk group (HRG), 40 carers with GHQ > 5 and GDS > 13. The optimal RSS cut-off to distinguish between the LRG and the others was > 23, whereas the optimal cut-off to separate the HRG from the others was >30. The RSS is a useful instrument to stratify carers according to their risk of psychiatric morbidity.