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Prevalenza dei disturbi affettivi (DSM-IIIR) nei pazienti di un reparto di medicina geriatrica. Uno studio epidemiologico con controlli della popolazione generale

Published online by Cambridge University Press:  07 August 2014

Cesare Turrina*
Affiliation:
Istituto di Psichiatria, Università di Verona, Verona
Maria Steinmayr
Affiliation:
Istituto di Psichiatria, Università di Verona, Verona
Orazio Piasere
Affiliation:
Istituto di Psichiatria, Università di Verona, Verona
Orazio Siciliani
Affiliation:
Istituto di Psichiatria, Università di Verona, Verona
*
Indirizzo per la corrispondenza: Dr. C. Turrina, Istituto di Psichiatria, Ospedale Policlinico, 37134 Verona. Fax ( + 039) 045-500.873.

Summary

Objective - To investigate the rate of DSM-IIIR main affective disorders in a sample (52) of elderly medical patients consecutively admitted to a geriatric ward; to look for risk factors associated with depression; to compare the rate of depression with the one detected in community controls (117 subjects). Design - All consecutive patients admitted during January-February 1990 were assessed with a standardized psychiatric interview (Geriatric Mental State Examination) and with the Mini-Mental State Examination. Setting - The IV Geriatric Division (ward and day-hospital), Ospedale Civile Maggiore of Verona, which cares for elderly affected by medical illnesses. Main outcome measures - Depression was diagnosed according to the main DSM-IIIR categories for mood disorders. Results - Overall, an affective disorder was diagnose in 25% of the subjects (major depression 5,7%, dysthymic disorder 3,8%, n.o.s. depression 13,4%, adjustment disorder with depressive mood 1,9%). This rate was significantly higher when compared with the prevalence detected in community controls (25% vs. 11,1%). Older age, female sex, physical disability and distressing events were not associated with affective illness, while the lack of social support was significantly associated with depression. Conclusions - Elderly medical patients turned out to be an high risk group for depression, which deserves psychiatric screening and specific treatment.

Type
Articoli
Copyright
Copyright © Cambridge University Press 1993

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References

BIBLIOGRAFIA

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (DSM III) (3rd ed. revised). American Psychiatric Association: Washington, D.C.Google Scholar
Andrews, G., Schonell, M. & Tennant, C. (1977). The relation between physical, psychological and social morbidity in a suburban community. American Journal of Epidemiology 105, 324329.CrossRefGoogle Scholar
Baldwin, R. C. & Jolley, D. J. (1986). The prognosis of depression in old age. British Journal of Psychiatry 149, 574583.CrossRefGoogle ScholarPubMed
Baratta, S., Colorio, C. & Zimmermann-Tansella, Ch. (1985). Interrater readability of the Italian version of the Paykel Scale of Stressfull Life Events. Journal of Affective Disorders 8, 279282.CrossRefGoogle Scholar
Belloc, N. B., Breslow, L. & Hochstim, R. J. (1971). Measurement of physical health in a general population survey. American Journal of Epidemiology 93, 328336.CrossRefGoogle Scholar
Bland, R. C., Newman, S. C. & Orn, H. (1988). Prevalence of psychiatric disorders in the elderly in Edmonton. In Epidemiology of Psychiatric Disorders in Edmonton, (ed. Bland, R. C., Newman, S. C. and Orn, H.), Acta Psychiatrica Scandinavica, Supplementum No. 338, vol. 77, pp. 5763.Google Scholar
Cole, M. G. (1990). The prognosis of depression in the elderly. Canadian Medical Association Journal 143, 633639.Google ScholarPubMed
Copeland, J. R. M., Kellehre, M. J., Gourlay, A. J., Gurland, B. J., Fleiss, J. L. & Sharpe, L. (1976). A semistructured clinical interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State Schedule. 1. Development and reliability. Psychological Medicine 6, 439449.CrossRefGoogle Scholar
Copeland, J. R. M., Dewey, M. E., Wood, N. D., Searle, R., Davidson, I. A. & McWilliam, C. (1987). Range of mental illness among the elderly in the community. Prevalence in Liverpool using the GMS-AGECAT pakage. British Journal of Psychiatry 150, 815823.CrossRefGoogle Scholar
Fava, G. A. & Osti, R. M. A. (1982). Versione Italiana della Scala di Paykel per gli Eventi Stressanti. Organizzazioni Speciali: Firenze.Google Scholar
Folstein, M. F., Folstein, F. E. & McHugh, P. R. (1975). «Mini Mental State»: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.CrossRefGoogle ScholarPubMed
Goldberg, D. P. & Huxley, P. (1991). Common Mental Disorders. A Bio-Social Approach. Tavistock-Routledge: London.Google Scholar
Henderson, A. S. (1990). The social psychiatry of later life. British Journal of Psychiatry 156, 645653.CrossRefGoogle ScholarPubMed
Henderson, A. S., Byrne, D. G. & Duncan-Jones, P. (1981). Neurosis and the Social Environment. Academic Press: London.Google Scholar
Ingham, J., Kreitman, N. B., Miller, P. McC., Sashidharan, S. P. & Surtees, P. G. (1986). Self-esteem, vulnerability and psychiatric disorders in the community. British Journal of Psychiatry 148, 375385.CrossRefGoogle ScholarPubMed
Katon, W. (1984). Depression: relationship to somatization and chronic medical illness. Journal of Clinical Psychiatry 45 (3, Sec. 2), 411.Google ScholarPubMed
Magni, G., De Leo, D. & Schifano, F. (1985). Depression in geriatric and adult medical inpatients. Journal of Clinical Psychology 42, 337344.3.0.CO;2-7>CrossRefGoogle Scholar
Mayou, R. & Hawton, K. (1986). Psychiatric disorder in the general hospital. British Journal of Psychiatry 149, 172190.CrossRefGoogle ScholarPubMed
O'Riordan, T. G., Hayes, J. P., Shelley, R., O'Neill, D., Bernard Walls, J. & Coakley, D. (1989). The prevalence of depression in an acute geriatric medical assessment unit. International Journal of Geriatric Psychiatry 4, 1721.CrossRefGoogle Scholar
Rabins, P. V., Merchant, A. & Nestadt, G. (1984). Criteria for diagnosing reversible dementia caused by depression: validation by 2-year follow up. British Journal of Psychiatry 144, 488492.CrossRefGoogle Scholar
Roding, G. & Voshart, K. (1986). Depression in the medically ill: an overview. American Journal of Psychiatry 143, 696705.Google Scholar
Siciliani, O., Poloni, C. & Zimmermann-Tansella, C. (1982). Anxiety and depression in 100 female geriatric inpatients. A psychopathological study. Psychopathology 17, 121127.Google Scholar
Tansella, M., Faccincani, C., Mignolli, G., Balestrieri, M. & Zimmermann-Tansella, Ch. (1985). Il Registro Psichiatrico di Verona-sud: epidemiologia per la valutazione dei nuovi servizi territoriali. In L'Approccio Epidemiologico in Psichiatria (ed. Tansella, M.), pp. 225259. Boringhieri: Torino.Google Scholar
Turrina, C., Perdonà, G., Bianchi, L., Cordioli, L., Burti, L. & Siani, R. (1990). Disturbi psichici (DSM-IIIR) nella popolazione anziana del quartiere di Verona-Sud. Dati preliminari. Rivista Sperimentale di Freniatria 64, 10061013.Google Scholar
Turrina, C., Perdonà, G., Bianchi, L., Cordioli, L., Burti, L., Micciolo, R. & Copeland, J. R. M. (1991). Inter-observer reliability of the Italian version of the Geriatric Mental State Examination (GMS). International Journal of Geriatric Psychiatry 6, 647650.CrossRefGoogle Scholar
Turrina, C., Steinmayr, M., Baratta, S. & Pasoli, R. (1992a). Disturbi psichici nel paziente anziano ricoverato per problemi fisici: rassegna critica della recente letteratura. Minerva Psichiatrica (in stampa).Google Scholar
Turrina, C., Siciliani, O., Dewey, M. E., Fazzari, G. C. & Copeland, J. R. M. (1992b). Psychiatric disorders among day-hospital geriatric medical patients: prevalence according to clinical diagnosis (DSM-III-R) and AGECAT. International Journal of Geriatric Psychiatry 7, 499504.CrossRefGoogle Scholar
Weissmann, M. M., Myers, J. K., Tiscler, G. L., Holzer, C. E. III, Leaf, P. J., Orvarschel, H. & Brody, J. A. (1985). Psychiatric disorders (DSM-III) and cognitive impairment among the elderly in a U.S. urban community. Acta Psychiatrica Scandinavica 71, 366379.CrossRefGoogle Scholar
Zimmermann-Tansella, Ch., Donini, S., Lattanzi, M., Siciliani, O., Turrina, C. & Wilkinson, G. (1991). Life events, social problems and physical health status as predictors of emotional distress in men and woman in a community setting. Psychological Medicine 21, 505513.CrossRefGoogle Scholar
Zung, W. W. K., Magill, M., Moore, J. T. & George, D. T. (1983). Recognition and treatment of depression in a family medicine practice. Journal of Clinical Psychiatry 44, 36.Google Scholar