Subject(s)
Health Services for the Aged , Patient Care Team , Physician's Role , Psychiatry , Role , Aged , HumansSubject(s)
Mental Disorders/diagnosis , Adaptation, Psychological , Aged , Alzheimer Disease/diagnosis , Antidepressive Agents/therapeutic use , Combined Modality Therapy , Crisis Intervention , Dementia/diagnosis , Depressive Disorder/diagnosis , Electroconvulsive Therapy , Humans , Mental Disorders/therapy , Neurotic Disorders/diagnosis , Personality Disorders/diagnosis , Psychotic Disorders/diagnosis , Social EnvironmentSubject(s)
Paranoid Disorders/diagnosis , Schizophrenia/diagnosis , Aged , Antipsychotic Agents/therapeutic use , Delusions/psychology , Dyskinesia, Drug-Induced/etiology , Hallucinations/psychology , Humans , Paranoid Disorders/drug therapy , Paranoid Disorders/psychology , Prognosis , Schizophrenia/drug therapy , Schizophrenia, Paranoid/diagnosis , Schizophrenic PsychologyABSTRACT
Although the elderly's need for psychiatric treatment has long been recognized, publicly funded community mental health centers generally have been unsuccessful in establishing geriatric programs. If properly used, state mental hospitals remain a potential resource, but the more appropriate community-based placement of mentally impaired elderly persons is in special psychiatric units of general hospitals or in geropsychiatric units of private psychiatric hospitals. Principles for establishing such units in either setting include organizing a treatment team that empathizes with older patients and that has been trained to deal with the complex problems of the elderly. Formulation of comprehensive diagnoses and prognoses may require consultation and facilities outside the hospital; treatment planning should involve the patient's family from the beginning. Follow-up and supervision of referral after the patient's discharge are essential to the program's success.
Subject(s)
Hospitals, Psychiatric/organization & administration , Mental Disorders/rehabilitation , Psychiatric Department, Hospital/organization & administration , Aged , Follow-Up Studies , Humans , Mental Disorders/psychology , Patient Care Planning/organization & administration , Patient Care Team/organization & administration , Psychotherapy , Social AdjustmentABSTRACT
Diagnosing mental illness in the elderly is difficult because changes in physical and psychologic functioning may mimic psychiatric disorders. The reverse is also true. Although chronologic age is not related directly to predisposition to mental illness, the stresses experienced by elderly persons as a result of declining health and loss of social status may result in mental disorders. Accurate diagnosis, which takes all these factors into account, is particularly important for the rational treatment of elderly patients.
Subject(s)
Chronic Disease/psychology , Mental Disorders/diagnosis , Adaptation, Psychological , Aged , Anxiety/diagnosis , Depression/diagnosis , Diagnosis, Differential , Female , Humans , Loneliness , Mental Disorders/psychology , Psychophysiologic Disorders/diagnosis , Social IsolationSubject(s)
Dementia/drug therapy , Dihydroergotoxine/therapeutic use , Aged , Alzheimer Disease/drug therapy , Humans , Middle Aged , ResearchABSTRACT
Retirement planning has become a legitimate concern of all physicians, especially those employed by agencies where retirement is compulsory. Faced with the possibility of retirement, whether forced or voluntary, and issues of competence and other related matters, many physicians are departing from the traditional pattern of working until they become incapacitated. The typical physician places high values on work and deprecates other activities. Busy practitioners who have spent little time with their families and in recreational pursuits find themselves unprepared for their altered status when they stop working. Little empirical information is available concerning physicians and retirement. Four proposed retirement patterns may help physicians plan successfully for retirement.
Subject(s)
Physicians , Retirement , Age Factors , Hobbies , Humans , Mental Disorders/epidemiology , Middle AgedABSTRACT
Evaluation of treatment modalities, including pharmacotherapy, for organic brain syndrome (OBS) has been difficult because of sampling and methodological problems, and comparisons of research studies are all but impossible. In this study, an ergot derivative, a combination of dihydroergocornine mesylate, dihydroergocristine mesylate, and dihydroergokryptine mesylate (Hydergine) was compared with placebo, using a double-blind technique in a sample of nursing home residents with evidence of OBS. An 18-category symptom rating scale was used for periodic assessment over a six-month interval. Comparisons of the two groups of subjects disclosed that the Hydergine-treated group showed statistically significantly more improvement in most of the variables measured, especially during the last three months of treatment. Furthermore, sophisticated analysis revealed that positive changes in cognitive function cannot be accounted for as a mere reflection, or "halo" effect, associated with improved mood and general sense of well-being.
Subject(s)
Dihydroergotoxine/therapeutic use , Neurocognitive Disorders/drug therapy , Administration, Oral , Aged , Cognition/drug effects , Dihydroergotoxine/administration & dosage , Drug Combinations , Drug Evaluation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Placebos , Psychiatric Status Rating Scales , Time FactorsABSTRACT
Data gathered in a survey of 1441 respondents were analyzed to study the influence of chronologmost equal representation of six age groups (20-29, 30-39, 40-54, 55-64, 65-74, 75-94), and three ethnic groups (Blacks, Anglos, Mexican-Americans). The sample includes equal representation of both sexes and two socioeconomic levels. The Twenty-two Item Screening Scale and the Affect Balance Scale are used as measures of mental health. The analyses show age-related and ethnic-related patterns; each pattern, however, is independent of the other. The age-related pattern is the same within the three ethnic groups, and the ethnic pattern is independent of age. Anglos report significantly more psychiatric symptoms, especially those of one factor grouping named "anxiety," and they report more recent experiences with both positive and negative affect than do Mexican-Americans and Blacks. The elderly persons "well enough" to participate in a long interview express no significant increase in symptomatology compared with younger groups. If the symptom expression is broken into several categories based on factor analysis, we find a small, significant increase in symptom expression by older groups on the factor grouping named "depression." Additionally, the older groups compared with middle-aged and younger groups, report less positive and negative affect expression.
