The Prognosis of Depression in Old Age

1983 ◽  
Vol 142 (2) ◽  
pp. 111-119 ◽  
Author(s):  
Elaine Murphy

SummaryThe paper describes a one year prospective study of 124 elderly depressed patients. Only one third of the group had a good outcome. Poor outcome was associated with severity of initial illness, those with depressive delusions having a particularly poor outcome. Outcome was also influenced by physical health problems and severe life events in the follow-up year. Social class differences in outcome were thought to be due to class differences in the experience of severe life events. There was no evidence that an intimate relationship protected against relapse in the face of continuing life stress.

2018 ◽  
Vol 56 (2) ◽  
pp. 231-235 ◽  
Author(s):  
Olivia E. Linden ◽  
Vanessa M. Baratta ◽  
Jose A. Gonzalez ◽  
Margaret E. Byrne ◽  
Petra M. Klinge ◽  
...  

Objective: To evaluate 3-dimensional (3-D) photogrammetry as a tool for assessing the postoperative head shape of patients who had undergone cranial vault remodeling for metopic synostosis. Design: We prospectively analyzed images of patients with metopic craniosynostosis who had undergone anterior cranial vault remodeling and age-matched controls. To ensure standardized facial orientation, each 3-D image was positioned to “best fit” the preoperative face by aligning 6 soft tissue landmarks. Forehead measurements were taken from a standardized position behind the surface of the face to landmarks placed in a ray configuration across the forehead. Setting: Academic teaching hospital. Patients, Participants: Thirteen pediatric patients with metopic craniosynostosis who had undergone anterior cranial vault remodeling and age-matched controls. Interventions: Images were taken preoperatively, immediately postoperatively, and over 1-year postoperatively. Main Outcome Measures: Forehead contours preoperatively and postoperatively, with statistics performed using a multivariate analysis of variance shape analysis. Results: Mean postoperative follow-up was 1.8 (0.6) years. The average distance from the origin to forehead landmarks was 55.1 (3.4) mm preoperatively, 59.3 (0.7) mm immediate postoperatively, 59.1 (1.0) mm 1-year postoperatively, and 59.4 (0.6) mm in controls. Postoperative metopic forehead contours varied significantly from preoperative contours ( P < .01), while there was no statistical difference between the 2 postoperative time points ( P = .70). One-year postoperative patients were not significantly different from their age-matched controls ( P > .99). Conclusions: Preoperative metopic forehead contours varied significantly from postoperative contours. Cranial reconstructions approximated the foreheads of normal controls, and reconstructions were stable at more than 1-year follow-up.


SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401882238 ◽  
Author(s):  
Minna Lyons ◽  
Kate Evans ◽  
Samuli Helle

Stressful life events have a major impact on adverse mental health outcomes, although not all individuals are equally affected. According to the buffering hypothesis, there may be personality traits that protect individuals against mental distress in the face of adversity, playing thus a moderating role between life stressors and mental distress. In the present online study ( N = 574), Dark Triad of personality (i.e., Machiavellianism, narcissism, and psychopathy) were investigated as moderators between cumulative stressful life events and mental distress (i.e., psychosis, anxiety, and depression). Those who experienced more stressful events during lifetime, and scored higher in Machiavellianism, had higher scores on a psychosis instrument. Narcissism buffered the impact of stressful events on psychosis and depression. The results are discussed in terms of unique profiles associated with each of the traits.


1979 ◽  
Vol 134 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Eve C. Johnstone ◽  
C. D. Frith ◽  
Aviva Gold ◽  
Marilyn Stevens

SummaryForty-five patients with acute schizophrenic illnesses (defined by PSE criteria) were assessed in clinical, cognitive and social terms before being entered in a four week study of the isomers of flupenthixol and placebo. At the end of one year they were re-assessed in the same terms. The clinical and psychological features of the acute illness and the drug treatment given did not predict outcome. Poor outcome in social terms was significantly related to severe social isolation in the initial assessment and to the presence of nuclear symptoms and negative schizophrenic features at follow-up.


2016 ◽  
Vol 46 (12) ◽  
pp. 2617-2626 ◽  
Author(s):  
T. R. Nicholson ◽  
S. Aybek ◽  
T. Craig ◽  
T. Harris ◽  
W. Wojcik ◽  
...  

BackgroundPsychological models of conversion disorder (CD) traditionally assume that psychosocial stressors are identifiable around symptom onset. In the face of limited supportive evidence such models are being challenged.MethodForty-three motor CD patients, 28 depression patients and 28 healthy controls were assessed using the Life Events and Difficulties Schedule in the year before symptom onset. A novel ‘escape’ rating for events was developed to test the Freudian theory that physical symptoms of CD could provide escape from stressors, a form of ‘secondary gain’.ResultsCD patients had significantly more severe life events and ‘escape’ events than controls. In the month before symptom onset at least one severe event was identified in 56% of CD patients – significantly more than 21% of depression patients [odds ratio (OR) 4.63, 95% confidence interval (CI) 1.56–13.70] and healthy controls (OR 5.81, 95% CI 1.86–18.2). In the same time period 53% of CD patients had at least one ‘high escape’ event – again significantly higher than 14% in depression patients (OR 6.90, 95% CI 2.05–23.6) and 0% in healthy controls. Previous sexual abuse was more commonly reported in CD than controls, and in one third of female patients was contextually relevant to life events at symptom onset. The majority (88%) of life events of potential aetiological relevance were not identified by routine clinical assessments. Nine per cent of CD patients had no identifiable severe life events.ConclusionsEvidence was found supporting the psychological model of CD, the Freudian notion of escape and the potential aetiological relevance of childhood traumas in some patients. Uncovering stressors of potential aetiological relevance requires thorough psychosocial evaluation.


Author(s):  
Mona Talaschian ◽  
Anahita Sadeghi ◽  
Sara Pakzad

Antimalarial agents, including chloroquine and hydroxychloroquine, have been used for the treatment of various rheumatoid diseases and skin diseases because of their anti-inflammatory and immune-modulating properties. Cutaneous adverse effects such as exacerbation of psoriasis, pruritus, and hyperpigmentation have been reported as side-effects of antimalarial drugs. In this case, we report a middle-aged man with a history of rheumatoid arthritis who was treated with non-steroidal anti-inflammatory drugs and hydroxychloroquine. He complainedof hyperpigmentation of the face after one year of initiating the hydroxychloroquine. It was discontinued and methotrexate was started. Skin biopsy was confirmed drug reaction. Aftermore than 10 years of follow up, his skin discoloration had not been improved.


2020 ◽  
Vol 26 (2) ◽  
pp. 20
Author(s):  
Samuel Macedo Costa ◽  
Bruna Campos Ribeiro ◽  
Bernardo Barcelos Greco ◽  
Rodolfo César Gual ◽  
Alessandro Oliveira de Jesus ◽  
...  

Spear gun projectiles injuries are are very rare and are usually related to lack of attention during water- sports or fishing practices. This study aims to describe an unusual case of facial injury associated with a mandibular fracture after a spear gun shot. A 38-years-old man was admitted with a history of penetrating injury on the face caused by an accidental shot from a spear gun. After the initial stabilization and examination, the patient was taken to the surgical room for the removal of the projectile. The post-operative care was uneventful and the patient was discharged with no concerns, being in follow-up for one year with no signs of infection or malocclusion. The surgical procedure should be done as soon as possible and the removal of the spear must be done carefully, under direct vision, with or without surgical incisions. Major complications can occur after spear injuries, therefore, the patient must be observed in the postoperative period and should maintain follow up until the end of the rehabilitative process.


2003 ◽  
Vol 9 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Craig Kennedy ◽  
Peter Yellowlees

In a telepsychiatry project in rural Queensland, data were collected from 124 patients attending hospital and general practice facilities for mental health-care and then again at follow-up one year later. Thirty-two of the patients were dealt with using telepsychiatry. Two health status scales were used to measure effectiveness: the Health of the Nation Outcome Scale (HoNOS), administered by the practitioners; and the Mental Health Inventory (MHI), which was self-administered by the patients. There was a significant difference between the initial assessment and follow-up groups on most subscales of the HoNOS, but no significant difference between the face-to-face and telepsychiatry groups. Similarly, the MHI results showed a significant difference on all subscales between the initial assessment and follow-up groups, but no significant difference between the face-to-face and telepsychiatry groups. Individuals who used and did not use telepsychiatry all had improved health outcome scores on the HoNOS and MHI during the study period. Telepsychiatry was as effective as face-to-face care.


2019 ◽  
Vol 8 (1) ◽  
pp. 10-16
Author(s):  
Nafisa Huq ◽  
Tarzia Choudhury ◽  
Samia Aziz ◽  
SM Yasir Arafat ◽  
M Omar Rahman

Depression is the leading cause of disability worldwide. However, it is under recognized and undertreated. Self-rated health is a one-item question that has been used for population health monitoring. It was aimed to examine the prospect of using ‘self-rated health’ (SRH) in identifying people with depression among adult community-based population in Bangladesh over a one-year period controlling for socio-demographic, chronic diseases and symptoms, physical disability, smoking, and life events. We examined data from 3455 participants aged 18 years and above who participated in the 2015 January and 2016 January Health and Socio-Economic Survey of Independent University, Bangladesh. Using multiple logistic regressions, depression at baseline was examined to predict self-rated health at one-year follow-up adjusting for socio-demographic variables, chronic diseases, risk behaviors, and life events. Respondents with depression at baseline had 35% higher odds of reporting poor SRH in the follow-up round compared to those with no depression (OR=1.35, 95% CI=1.03 1.78, P<0.03). SRH may be used by community health workers as a preliminary indicator to identify people who may have depression followed by further screening and management for depression. South East Asia Journal of Public Health Vol.8(1) 2018: 10-16


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