Prognosis in Psychiatric Disorders of the Elderly an Attempt to Define Indicators of Early Death and Early Recovery

1956 ◽  
Vol 102 (426) ◽  
pp. 129-140 ◽  
Author(s):  
D. W. K. Kay ◽  
Vera Norris ◽  
Felix Post
Keyword(s):  
Psychiatric Patients ◽  
Medical Practitioner ◽  
Early Death ◽  
The Elderly ◽  
Original Data ◽  
Response To Treatment ◽  
Early Recovery ◽  
Treatment Facilities ◽  
Post Hoc

Prognosis, the prediction of the outcome of an illness, has long been recognized as a necessary skill of a physician. Hippocrates (translated Chadwick and Mann, 1950) said:“It seems highly desirable that a physician should pay much attention to prognosis. If he is able to tell his patients when he visits them not only about their past and present symptoms, but also to tell them what is going to happen, as well as to fill in the details they have omitted, he will increase his reputation as a medical practitioner … It is impossible to cure all patients: that would be an achievement surpassing in difficulty even the forecasting of future developments … By realizing and announcing beforehand which patients were going to die he would absolve himself from any blame.”In addition to the reasons given by our distinguished forebear we now also require to read into the future so that we can make the best use of the limited facilities available for the sick. This is particularly true for elderly psychiatric patients for whom treatment facilities are still very inadequate. It has been suggested (Cook, Dax and Maclay, 1952) that mentally ill elderly people should by preference be admitted to short-stay units attached to general hospitals for the assessment of prognosis and probable response to treatment. They suggested that a 3-4-months stay might be necessary. Experience in a diagnostic outpatient clinic (Norris and Post, 1954) led one of us (F.P.) to believe that it should be possible to classify patients according to the best method of dealing with them in a shorter time even than the six weeks recommended by the B.M.A. Report (1947). The present study was designed to test this belief. Our hopes were only partly fulfilled, but a post hoc analysis of our original data, in conjunction with the known results of the follow-up of cases, has suggested that with more knowledge of the factors influencing prognosis over a short term, much more accurate forecasts could have been achieved. The second half of this paper is devoted to a discussion of these factors. A preliminary report was given at the Third International Congress of Gerontology (Kay et al., 1954).

The Use and Misuse of Psychotropic Prescribing for Elderly Psychiatric Patients

1988 ◽  
Vol 33 (7) ◽  
pp. 585-589 ◽  
Author(s):  
R.J. Ancill ◽  
G.D. Embury ◽  
G.W. Macewan ◽  
J.S. Kennedy
Keyword(s):  
Psychiatric Patients ◽  
The Elderly ◽  
Depressive Illness ◽  
Response To Treatment ◽  
Behaviour Problems ◽  
Presenting Problems ◽  
Retrospective Survey ◽  
Significant Incidence ◽  
Assessment Unit ◽  
Diagnosis Of Dementia

The presenting problems and pre-admission diagnoses of 100 consecutive admissions to a geriatric psychiatry inpatient assessment unit were assessed in a retrospective survey and the use of psychotropic medication examined. Although post-admission diagnoses showed a high proportion of depressive illness amongst the patients, depression was infrequently diagnosed prior to admission and antidepressants infrequently used. The majority of these elderly patients were referred with a diagnosis of dementia and ‘behaviour problems’. These were treated prior to admission with neuroleptics or benzodiazepines in line with prescribing habits in this population reported elsewhere in North America. Attention is drawn to the significant incidence of major depression in these patients and the excellent response to treatment, both with chemotherapy or with electrotherapy. Attention is also drawn to the pre-admission prescribing of psychotropic drugs which are likely to lead to problems when used in the elderly and likely to result in significant iatrogenic disorders.

Quantitative Electroencephalography Findings in Patients With Diabetes Mellitus

2021 ◽  
pp. 155005942199765
Author(s):  
Özden Öksüz ◽  
Mehmet Güven Günver ◽  
Mehmet Kemal Arıkan
Keyword(s):  
Diabetes Mellitus ◽  
Psychiatric Patients ◽  
Response To Treatment ◽  
Control Group ◽  
Alpha Power ◽  
Quantitative Electroencephalography ◽  
Eyes Closed ◽  
Patients With Diabetes ◽  
The Absolute

Objective. Diabetes mellitus (DM) causes structural central nervous system (CNS) impairment, and this situation can be detected by quantitative electroencephalography (QEEG) findings before cognitive impairment is clinically observed. The main aim of this study is to uncover the effect of DM on brain function. Since QEEG reflects the CNS functioning, particularly in cognitive aspects, we expected electrophysiological clues to be found for prevention and follow-up in DM-related cognitive decline. Since a majority of the psychiatric population have cognitive dysfunction, we have given particular attention to those people. It was stated that a decrease was observed in the posterior cortical alpha power due to the hippocampal atrophy by several previous studies and we hypothesize that decreased alpha power will be observed also in DM. Methods. This study included 2094 psychiatric patients, 207 of whom were diagnosed with DM and 1887 of whom were not diagnosed with DM, and QEEG recordings were performed. Eyes-closed electroencephalography data were segmented into consecutive 2 s epochs. Fourier analysis was performed by averaging across 2 s epochs without artifacts. The absolute alpha power in the occipital regions (O1 and O2) of patients with and without DM was compared. Results. In the DM group, a decrease in the absolute alpha, alpha 1, and alpha 2 power in O1 and O2 was observed in comparison with the control group. It was determined that the type of psychiatric diagnosis did not affect QEEG findings. Conclusion. The decrease in absolute alpha power observed in patients diagnosed with DM may be related to the CNS impairment in DM. QEEG findings in DM can be useful while monitoring the CNS impairment, diagnosing DM-related dementia, in the follow-up of the cognitive process, constructing the protocols for electrophysiological interventions like neurofeedback and transcranial magnetic stimulation and monitoring the response to treatment.

Resettlement of Old Long-Stay Psychiatric Patients: the use of the Private Sector

1989 ◽  
Vol 155 (2) ◽  
pp. 233-238 ◽  
Author(s):  
Rachel E. Perkins ◽  
Sylvia A. King ◽  
Julie A. Hollyman
Keyword(s):  
Social Environment ◽  
Rating Scale ◽  
Local Authority ◽  
Psychiatric Patients ◽  
The Elderly ◽  
Follow Up Study ◽  
Behaviour Rating ◽  
Safety Features

A follow-up study of 17 old long-stay psychiatric patients resettled in private facilities for the elderly is reported. Resident satisfaction with the placement and functioning (using the CAPE Behaviour Rating Scale) was assessed, together with the quality of the physical and social environment, and the regime characteristics in the establishments. All residents were satisfied with life and their functioning had improved significantly. The private facilities were more resident-orientated, and had a generally superior social environment to their local authority ‘old people's home’ counterparts. The physical amenities, safety features, and architectural choice available were of a similar standard to those in local authority old people's homes, but there were fewer prosthetic and orientational aids and on-site recreational amenities.

Depression and Previous Alcoholism in the Elderly

1991 ◽  
Vol 158 (1) ◽  
pp. 72-75 ◽  
Author(s):  
Brian L. Cook ◽  
George Winokur ◽  
Michael J. Garvey ◽  
Vickie Beach
Keyword(s):  
Risk Factor ◽  
Elderly Population ◽  
Bipolar Depression ◽  
Past History ◽  
Previous History ◽  
The Elderly ◽  
Response To Treatment ◽  
History Of ◽  
A Prospective Study

A prospective study of male in-patients over 55 years old who met Feighner criteria for non-bipolar depression was performed to determine if a previous history of alcoholism significantly influenced treatment or response to treatment. Among 58 subjects with complete follow-up information, the 16 who had a history of alcoholism had a presentation at index which differed from that of the non-alcoholics, and on follow-up they clearly had more chronic illness. This elderly sample with alcoholism resembles ‘neurotic-reactive’ depressives described in younger samples, and supports a past history of alcoholism as being a risk factor for chronicity of depression on follow-up in the elderly population.

The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

2019 ◽  
Vol 28 (3) ◽  
pp. 1039-1052
Author(s):  
Reva M. Zimmerman ◽  
JoAnn P. Silkes ◽  
Diane L. Kendall ◽  
Irene Minkina
Keyword(s):  
Short Term Memory ◽  
Controlled Trial ◽  
Treatment Success ◽  
Linear Regression Models ◽  
Language Performance ◽  
Short Term ◽  
Term Memory ◽  
Treatment Gains ◽  
Post Hoc

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

Evaluation of R-CHOP and R-CVP in the treatment of elderly patient with non-Hodgkin lymphoma

MedPharmRes ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 1-6
Author(s):  
Truc Phan ◽  
Tram Huynh ◽  
Tuan Q. Tran ◽  
Dung Co ◽  
Khoi M. Tran
Keyword(s):  
Elderly Patients ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
The Elderly ◽  
Free Survival ◽  
Non Hodgkin Lymphoma ◽  
Common Sign ◽  
Related Mortality

Introduction: Little information is available on the outcomes of R-CHOP (rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone) and R-CVP (rituximab with cyclophosphamide, vincristine and prednisone) in treatment of the elderly patients with non-Hodgkin lymphoma (NHL), especially in Vietnam. Material and methods: All patients were newly diagnosed with CD20-positive non-Hodgkin lymphoma (NHL) at Blood Transfusion and Hematology Hospital, Ho Chi Minh city (BTH) between 01/2013 and 01/2018 who were age 60 years or older at diagnosis. A retrospective analysis of these patients was perfomed. Results: Twenty-one Vietnamese patients (6 males and 15 females) were identified and the median age was 68.9 (range 60-80). Most of patients have comorbidities and intermediate-risk. The most common sign was lymphadenopathy (over 95%). The proportion of diffuse large B cell lymphoma (DLBCL) was highest (71%). The percentage of patients reaching complete response (CR) after six cycle of chemotherapy was 76.2%. The median follow-up was 26 months, event-free survival (EFS) was 60% and overall survival (OS) was 75%. Adverse effects of rituximab were unremarkable, treatment-related mortality accounted for less than 10%. There was no difference in drug toxicity between two regimens. Conclusions: R-CHOP, R-CVP yielded a good result and acceptable toxicity in treatment of elderly patients with non-Hodgkin lymphoma. In patients with known cardiac history, omission of anthracyclines is reasonable and R-CVP provides a competitive complete response rate.

Response to Treatment of Alcoholism; a Follow-Up Study

1968 ◽  
Vol 29 (2) ◽  
pp. 364-381 ◽  
Author(s):  
Alex D. Pokorny ◽  
Byron A. Miller ◽  
Sidney E. Cleveland
Keyword(s):  
Response To Treatment ◽  
Follow Up Study

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

scholarly journals Impacts of Faith-Based Lifestyle Interventions on Congregational-Level Nutrition and Physical Activity Environment and Policies

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 300-300
Author(s):  
Summer Wilmoth ◽  
Leah Carrillo ◽  
Elana Martinez ◽  
Raymundo Mendoza Mendoza ◽  
Lauren Correa ◽  
...  
Keyword(s):  
Physical Activity ◽  
Program Effectiveness ◽  
San Antonio ◽  
Macro Level ◽  
Policy Changes ◽  
Environment Policy ◽  
Post Hoc Analysis ◽  
Faith Based ◽  
Post Hoc

Abstract Objectives Hispanics are disproportionally affected by obesity, cancer, and other obesity-related chronic diseases. Building a Healthy Temple (BHT) was a multi-component, faith-based lifestyle intervention implemented in 27 low-income, predominately-Hispanic congregations in San Antonio, TX between 2012 and 2017. One aim of BHT was to assess program effectiveness at improving health-conducive church environment/policy and sustainability of these improvements at follow-up. Methods A key macro-level program component of BHT was the formation of a Health Ministry Committee to initiate church-wide health-conducive environment/policy changes. The Congregational Health Index (CHI) was used to assess church nutrition (17 items) and physical activity (PA, 5 items) environment/policy at baseline, end of program, and follow-up (6 months or more post-intervention). Data were expressed as % of the maximum scores. Friedman test and post hoc analysis were performed with Wilcoxon signed-rank tests and significance of pairwise comparisons, adjusted with Bonferroni correction. Results Eighteen churches completed all 3 CHI assessments. Percentage of total nutrition and PA environment/policy scores for baseline, end of program, and follow-up were 38% (35–45), 64% (53–75), and 69% (64–77), respectively. Post hoc analysis shows significant improvements in nutrition and PA environment/policy scores at end of program (Z = –3.73, P &lt; 0.001) and follow-up (Z = –3.73, P &lt; 0.001) as compared to baseline, as well as significantly higher scores at follow-up compared to end of program (Z = –3.18, P = 0.001). Conclusions Study findings reveal the importance of utilizing congregation-wide macro-level interventions to create health-conducive enviroment/policy changes to facilitate and sustain healthy lifestyle changes in predominately-Hispanic faith community settings. Funding Sources Baptist Health Foundation San Antonio & Cancer Prevention Research Institute of Texas.

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