[Association between emotional disorders and ophthalmopathology in residents of the Arkhangelsk region at the age of 60-74 years.]

A study was conducted to investigate the associations of the diseases of the organ of vision and its accessory apparatus with anxiety and depression in the elderly people. The study included 678 participants of the ESSE-RF3 population study in the Arkhangelsk region in the age of 60-74 years. We used a questionnaire, including the hospital scale of anxiety and depression score (HADS), and the assessment of the ophthalmological status. It was found that all the study participants had diseases of the visual organ. Elevated depression scores were associated with sex, age, marital status (being single), and disability, elevated anxiety scores - with sex. The scores on the anxiety scale were on average 25% higher in participants whose visual acuity decreased to 0,5 units, and showed no independent associations with diagnosed ophthalmological diseases. The scores on the depression scale were on average 33% higher in participants with visual acuity 0,5 units, and 22% higher in the presence of retinopathy. In conclusion, anxiety and depression in the elderly people were more associated with visual deficits rather than with the presence of ophthalmological diseases underlying a decrease in functional status.

[Psychiatry of the elderly: a sometimes complex clinical picture]. / Psychiatrie du sujet âgé : un tableau clinique parfois complexe.

Psychiatry of the elderly is a discipline that focuses on the subject as a whole. The interaction of psychiatric, neurological and somatic pathologies impacts the elderly subject on a functional, psychological and social level. Multidisciplinary care is therefore essential to build a complete therapeutic project and to accompany the patient in the plurality of his problems.

[Weaving with Ti-Sage]. / Tisser avec Ti-Sage.

The Ti-Sage mobile geronto-psychiatry team provides semi-emergency care in the Sud Bretagne public mental health establishment sector. The system favours fluidity and responsiveness. Requests can be made by telephone without filling in a form. The multidisciplinary team assesses the disorders, directs and ensures follow-up as close as possible (living and care areas), quickly (within forty-eight hours), with the aim of forging links and avoiding inappropriate hospitalisations. Interventions are carried out in all the geriatric care structures in the area, by visit or telemedicine. The team works in a network to coordinate care with care partners and offer support to carers.

[Complex treatment of severe mental illnesses in old age]. / Komplexbehandlung bei schweren psychischen Erkrankungen im Alter ­ eine Positionsbestimmung.

BACKGROUND: The needs for assistance, support and treatment of older people with severe mental illnesses (SMI) are very high and linked to additional age-associated somatic diseases and impairments. Old people prefer to live independently in their own homes and to receive necessary treatment and support there; however, a resettlement in a residential nursing home is often necessary due to a lack of alternatives. OBJECTIVE: What is the current treatment reality in Germany for old people with SMI in their own homes and in residential nursing homes? How can coercive measures in this context be prevented? METHODS: Selected results from the scientific literature on psychogeriatric care models in older people with SMI are summarized and discussed. RESULTS: Multiprofessional psychogeriatric complex treatment models for older patients that include home visits and are adapted to the severity of mental disease are not available in Germany due to the lack of cross-sectoral network structures. Around 30% of the 730,000 nursing home residents in Germany experience coercive practices, whereas person-centered nursing concepts as well as guideline conform and individualized nonpharmacological treatment strategies and milieu therapeutic concepts are not sufficiently available. CONCLUSION: The German healthcare system is in urgent need of multiprofessional psychogeriatric home treatment models in old people with severe mental illness in order to prevent worsening of psychiatric and somatic symptoms, to maintain individual social involvement, to strengthen individual autonomy and participative decision making and to protect from coercion. Multiprofessional expertise is essential as well as effective age-appropriate service models with multiprofessional teams delivering domiciliary visits and connecting complementary services for individual treatment requirements as part of the German health care system.

[A study of the duration of the disease as a risk factor for the development of hospitalization in elderly psychiatric patients.]

Phenomenon of hospitalism in elderly patients with mental disorders is an extremely important clinical, social and economic problem. 155 patients of the gerontopsychiatric hospital were examined, 75 of them showed signs of hospitalism, and 80 made up a control group. A subgroup of patients with signs and short duration of the disease was isolated, the duration of treatment in the hospital of these patients was 133,5±42,24 days (in the corresponding control subgroup 72,11±37,11 days, p<0,05). This subgroup was characterized by greater impulsiveness as a personality trait and less adaptive coping strategies. A subgroup of patients with signs of hospitalism and a longer duration of the disease also had a longer stay in the hospital compared to patients with a similar experience of illness without hospitalism (249,67±63,56 and 79,58±39,52 days, respectively, p<0,05). For this subgroup of patients, the factors associated with the development of hospitalism were higher anxiety and depression in the current psychoemotional state, a smaller representation of adaptive cognitive coping and less sensitivity to the disease, all differences are significant at p<0,05.

[Psychiatry in elderly prisoners]. / Psychiatrie du sujet âgé en milieu pénitentiaire.

CONTEXT: The high prevalence of psychiatric disorders in prison and the aging of inmates should lead to the consideration of gerontopsychiatry in the prison environment. OBJECTIVE: This review aims to emphasize the clinical characteristics and associated comorbidities of elderly prisoners with psychiatric disorders. We examined the international literature in September 2013 and performed the literature search with PubMed electronic database using the following Mesh headings: "prisons", "prisoners", "geriatric psychiatry", "geriatric assessment", "geriatric nursing". RESULTS: Fourteen studies were retained by the literature search strategy and were included in the qualitative analysis. More than one out of two elderly prisoners (>60 year-old) suffer from a psychiatric disorder. Major depressive disorder (MDD) is the first psychiatric disorder diagnosed among elderly prisoners, affecting 30 to 50% of them. Personality disorders are also very common demonstrating a prevalence of about 30%. Psychotic disorders concern 5% of the elderly prisoners and thus largely exceed the prevalence in the general population. Furthermore, stress events are frequent in prison and might precipitate or worsen psychiatric disorders. This review highlights the difficulties and complexities of care plans and management for the elderly in prison. CONCLUSION: The situation of elderly prisoners with psychiatric disorders is extremely worrying. In addition, both the aging of the population and the lengthening of incarcerations increase the number of elderly prisoners, widely exposed to psychiatric disorders, and thus will probably worsen these issues in the future.

Characteristics of older patients in the largest French psychiatric emergency centre.

Despite an increasing number of adults older than 60 years with psychiatric disorders, there are few studies on older patients in psychiatric emergencies and no European data. We aimed to describe the population of patients aged 60 years and older who presented to the main French psychiatric emergency centre and identify predictors of psychiatric hospitalization. This monocentric study included 300 consecutive patients aged 60 years and older. Patients presenting because of psychiatric emergencies were frequently female and lived autonomously. More than 40% had a history of at least one psychiatric hospitalization and 44% had consulted a psychiatrist in the previous 6 months. The most common reasons for consultation were depression, anxiety, sleep disorders and suicidal thoughts. Psychiatric disorders were mainly mood disorders; neurotic, stress-related and somatoform disorders; and schizophrenic, schizotypal and delusional disorders. Only 10% had a diagnosis of organic mental disorders. Overall, 39% of the patients were admitted to the psychiatric hospital. Factors predicting hospitalization were a history of psychiatric hospitalization, suicidal thoughts and a diagnosis of a mood disorder or schizophrenia/schizotypal/delusional disorder. In conclusion, among people aged 60 years and older who consulted for psychiatric emergencies, 39% had to be hospitalized in psychiatry and only psychiatric factors influenced the decision to hospitalize. Our study highlights the need for further studies of older people in psychiatric emergencies in Europe, to anticipate the needs of this specific population and adapt multidisciplinary mental health care.

Public knowledge and attitudes about mental health in older age in Germany - Focus on dementia and late-life depression.

Older people with mental disorders represent a particularly vulnerable group in the health care system. Despite this, mental disorders in this group often remain undiagnosed or are not treated in accordance with guidelines, potentially due to a lack of knowledge or unfavorable attitudes regarding mental disorders in older individuals. Therefore, in an anonymous online survey of 1,284 participants (71.8% female, mean age 52.3 ± 18.0 years), we assessed knowledge and attitudes regarding mental health in old age in general and regarding dementia and late-life depression in particular. Regression analyses were conducted to determine predictors of higher knowledge and more favorable attitudes based on sociodemographic data. On average, participants answered 11 ± 2 out of 15 of the knowledge questions correctly. Items on the prevention of dementia, late-life depression symptoms, and associated suicide risk were most likely to be answered incorrectly. Participants showed less favorable attitudes towards people living with dementia than towards people with late-life depression, and higher knowledge scores were associated with more favorable attitudes. Our findings highlight a clear need for psychoeducation in the field of dementia and late-life depression, with a special emphasis on prevention-related knowledge. Fostering knowledge in this area is highly relevant, as it might positively influence attitudes towards older people with mental disorders, in turn facilitating health care and health-promoting behavior among older people.

[Transports and hospitalizations avoided thanks to teleconsultations for elderly patients living in nursing homes]. / Déplacements et hospitalisations évités grâce aux téléconsultations pour les patients hébergés en Ehpad.

INTRODUCTION: The care of elderly people living in nursing homes is a medical public health issue. The objective of this study is to evaluate the number of hospitalizations and transports avoided thanks to teleconsultations and to evaluate the therapeutic and follow up consequences of these teleconsultations. METHODS: A retrospective descriptive study of cardiology and neuropsychogeriatric teleconsultations was performed in three nursing home participating in the TokTokDoc Mobile Polyclinic project between September 1st, 2020 and February 28, 2021. RESULTS: We included 77 patients who had a total of 120 teleconsultations. Sixty-seven transports (55.8%) and 12 hospitalizations (10%) were avoided. Therapeutic optimization was achieved in 38 cases (40%). Complex medical assessments were carried out in the same way as a face-to-face consultation. CONCLUSION: Telemedicine is a relevant tool for improving the healthcare circuit care of residents, by avoiding medical transport and hospitalizations. These preliminary results also show the feasibility of teleconsultations in cardiology and neuropsychogeriatrics despite the medical complexity of these two specialties.

[Geriatric Psychiatry in Nursing Homes in the Canton Basel-Stadt - The View of General Practitioners]. / Die hausärztliche gerontopsychiatrische Versorgung in Stadtbasler Alters- und Pflegeheimen.

Geriatric Psychiatry in Nursing Homes in the Canton Basel-Stadt - The View of General Practitioners Abstract. Background: This cross-sectional study intends to examine the potential need for an outpatient geronto-psychiatric service and evaluates GPs' views of the frequency of psychiatric symptoms among residents of nursing homes in the canton of Basel-Stadt, Switzerland. Results: Nine out of ten (89 %) see a need for a geronto-psychiatric service. Two thirds (58,9 %) of them prefer a service available during office hours. GPs estimate that 63 % of their nursing home residents suffer from psychiatric symptoms (dementia in 60 %, depression in 23 %, sleep disorders in 11 %). Antipsychotics are prescribed most often (in 50,6 %). Discussion: GPs in the canton of Basel-Stadt see a need for an outpatient geronto-psychiatric service. Psychiatric symptoms are common among residents of nursing homes.

[Neurotic disorders as a problem of modern gerontopsihiatry]. / Nevroticheskie rasstroistva kak problema sovremennoi gerontopsikhiatrii.

The relevance of the problem is determined by the growth of elderly population in the world and in Russia and by the increase in the frequency of non-psychotic mental disorders (non-PMD) in the structure of psychiatric diseases. The authors consider the current state of research in the field of non-PMD of old age, including neurotic disorders (ND). An analysis of the literature has shown that there is no convergent view on the ND of old age. As a consequence, there are contradictory views from researchers or psychiatric schools on the ND prevalence and morbidity. Attention is drawn to the insufficient diagnosis of non-PMD in the primary link of health care, difficulties of distinguishing ND from neurotic-like states, necessity in the clarification of the epidemiology of neuroses and efficiency of psychotherapeutic help. The use of resources of able-bodied people is important for the socio-economic development of the country.