ABSTRACT
Psychotic symptoms can manifest at any age, but in the elderly they represent a real diagnostic challenge. Thought disorders, hallucinations (usually visual), mood disorders with delusions, impairment of social interaction and occasionally verbal or physical aggression may be observed (Karon & VandenBos, 1998). Since the first descriptions of classical psychiatry, attempts have been made to define the psychoses observed in the elderly and determine whether they are primary "psychiatric" syndromes or, conversely, whether they can be attributed to other pathologies. Thus, different concepts have emerged, such as Late Onset Psychosis or Late-Onset Schizophrenia, Very Late-Onset Psychosis or Very Late-Onset Schizophrenia-Like Psychosis VLOSL), Late-Life Psychosis, etc.
Los síntomas psicóticos pueden manifestarse a cualquier edad, pero en las personas mayores representan un verdadero desafío diagnóstico. Pueden observarse trastornos del pensamiento, alucinaciones (usualmente visuales), trastornos del estado de ánimo con ideas delirantes, trastornos en la interacción social y ocasionalmente agresividad verbal o física (Karon & VandenBos, 1998). Desde las primeras descripciones de la psiquiatría clásica se ha intentado definir a las psicosis observadas en las personas mayores y determinar si se trata de síndromes "psiquiátricos" primarios o, por el contrario, si se los puede atribuir a otras patologías. Así, han surgido diferentes conceptos, como psicosis de comienzo tardío (Late Onset Psychosis) o esquizofrenia de comienzo tardío (Late-Onset Schizophrenia - LOS), psicosis de comienzo muy tardío (Very Late-Onset Psychosis)o psicosis esquizofreniforme de comienzo muy tardío (very late-onset schizophrenia-like psychosis - VLOSL), psicosis de la vida avanzada (Late-Life Psychosis), etc.
Subject(s)
Psychotic Disorders , Humans , Retrospective StudiesABSTRACT
BACKGROUND: Social support is crucial for persons with multiple sclerosis (MS). We sought to analyze differences in perceived social support in persons with MS vs controls; to study associations between perceived social support, clinical measures, and health-related quality of life (HRQOL) variables in persons with MS; and to establish a predictive value of perceived social support for HRQOL. METHODS: We studied 151 persons with MS (mean ± SD: age, 42.01 ± 9.97 years; educational level, 14.05 ± 3.26 years) and 89 controls (mean ± SD: age, 41.46 ± 12.25 years; educational level, 14.60 ± 2.44 years) using the Medical Outcomes Study Social Support Survey (MOS-SSS), Expanded Disability Status Scale, Fatigue Severity Scale, Beck Depression Inventory, and Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire. Parametric and nonparametric statistical methods were used accordingly; P < .05. RESULTS: Persons with MS exhibited lower scores on the MOS-SSS's overall support index (t238 = -1.98, P = .04) and on each functional subscale (t238 = -2.56 to -2.19, P < .05). No significant differences were found on the social support structural component (P > .05). Significant associations were observed between social support and depression and fatigue (r = -0.20 to -0.29, P < .05) and with MusiQoL dimensions (r = -0.18 to 0.48, P < .05). Multiple regression analysis showed all 4 tested models contributed to HRQOL-explained variance (41%-47%). The emotional/informational support model explained the most HRQOL variability (47%). CONCLUSIONS: Persons with MS perceived reduced social support, presenting lower functional scores than controls. Perceived social support proved to be a predictor of HRQOL. These findings should be considered during therapeutic treatment.
ABSTRACT
OBJECTIVES: To study the relationship between perceived fatigue and heath related quality of life (HRQoL), social support and cognition in an Argentinean population of patients with MS (PwMS). PATIENTS AND METHODS: 128 PwMS were studied, 75 women (58 %). Mean age: 40⯱â¯10.49 years-old, education: 14⯱â¯3.04, Expanded Disability Status Scale (EDSS): 2.43⯱â¯1.87, evolution: 10.07⯱â¯7.23 years. INSTRUMENTS: Fatigue Severity Scale (FSS); EDSS; Beck's Depression Inventory II (BDI-II); International Quality of Life questionnaire (MusiQoL); Medical Outcomes Study Social Support Survey (MOS); BICAMS Battery, 7/24 Spatial Recall Test, Paced Auditory Serial Task (PASAT-3), Word list generation task (WLG). RESULTS: Sixty-six patients (51.6 %) presented fatigue. Significant differences were found between fatigued and non-fatigued patients in EDSS and BDI II (pâ¯<â¯0.001). Fatigue was associated with age, EDSS and BDI II (pâ¯<â¯0.05). When analyzing differences in HRQoL between fatigued and non-fatigued patients statistically significant differences were found in MusiQol (pâ¯<â¯0.05). FSS proved to be an independent predictor of HRQoL (typified ß =-0.612 and -0.287, pâ¯<â¯0.05). Fatigued patients had fewer friends in their social support network (pâ¯=â¯0.031) and worse performance in PASAT. FSS was established as an independent predictor of PASAT (ß = -0.280, pâ¯=â¯0.009) CONCLUSION: Fatigue is one of the most common symptoms in Multiple Sclerosis (MS) and has a great impact on patients daily life. This study highlights the importance of studying fatigue and treating it properly, since otherwise, it contributes to the dysfunction of patients daily life with psychological and social consequences.
