Personality, psychosocial and health-related predictors of quality of life in old age.

OBJECTIVES: Beyond its well-documented association with depressive symptoms across the lifespan, at an individual level, quality of life may be determined by multiple factors: psychosocial characteristics, current physical health and long-term personality traits. METHOD: Quality of life was assessed in two distinct community-based age groups (89 young adults aged 36.2 ± 6.3 and 92 older adults aged 70.4 ± 5.5 years), each group equally including adults with and without acute depressive symptoms. Regression models were applied to explore the association between quality of life assessed with the World Health Organization Quality of Life - Bref (WHOQOL-Bref) and depression severity, education, social support, physical illness, as well as personality dimensions as defined by the Five-Factor Model. RESULTS: In young age, higher quality of life was uniquely associated with lower severity of depressive symptoms. In contrast, in old age, higher quality of life was related to both lower levels of depressive mood and of physical illness. In this age group, a positive association was also found between quality of life and higher levels of Openness to experience and Agreeableness personality dimensions. CONCLUSION: Our data indicated that, in contrast to young cohorts, where acute depression is the main determinant of poor quality of life, physical illness and personality dimensions represent additional independent predictors of this variable in old age. This observation points to the need for concomitant consideration of physical and psychological determinants of quality of life in old age.

[The role of the primary care physician in the care of the psychotic patient]. / Rôle du médecin de premier recours dans la prise en charge du patient psychotique.

The primary care physician (PCP) plays an important role in the outpatient care of psychotic patients, particularly in the early detection of these disorders. Through the PCP's status as a trusted individual who knows the patient and his/her family, his/her opinion and attitude influence treatment acceptance and, consequently, the prognosis. By ensuring the continuity of care, in collaboration with a psychiatrist, the PCP helps prevent relapse and the evolution towards chronicity and long-term handicaps. A high incidence of cardiopulmonary disease and concomitant substance abuse in the population of chronic psychotic patients, as well as the monitoring of potential somatic side effects of psychotropic medication, require regular somatic follow-up by the PCP.