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5 results

  • Somatic disease burden and depression risk in late life: a community-based study

  • Federico Triolo, Davide Liborio Vetrano, Linnea Sjöberg, Amaia Calderón-Larrañaga, Martino Belvederi Murri, Laura Fratiglioni, Serhiy Dekhtyar
  • Journal:
    Epidemiology and Psychiatric Sciences / Volume 33 / 2024
    Published online by Cambridge University Press:
    08 February 2024, e6
    • Article
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  • Aims

    Co-occurring somatic diseases exhibit complex clinical profiles, which can differentially impact the development of late-life depression. Within a community-based cohort, we aimed to explore the association between somatic disease burden, both in terms of the number of diseases and their patterns, and the incidence of depression in older people.

    Methods

    We analysed longitudinal data of depression- and dementia-free individuals aged 60+ years from the population-based Swedish National Study on Aging and Care in Kungsholmen. Depression diagnoses were clinically ascertained following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision over a 15-year follow-up. Somatic disease burden was assessed at baseline through a comprehensive list of chronic diseases obtained by combining information from clinical examinations, medication reviews and national registers and operationalized as (i) disease count and (ii) patterns of co-occurring diseases from latent class analysis. The association of somatic disease burden with depression incidence was investigated using Cox models, accounting for sociodemographic, lifestyle and clinical factors.

    Results

    The analytical sample comprised 2904 people (mean age, 73.2 [standard deviation (SD), 10.5]; female, 63.1%). Over the follow-up (mean length, 9.6 years [SD, 4 years]), 225 depression cases were detected. Each additional disease was associated with the occurrence of any depression in a dose–response manner (hazard ratio [HR], 1.16; 95% confidence interval [CI]: 1.08, 1.24). As for disease patterns, individuals presenting with sensory/anaemia (HR, 1.91; 95% CI: 1.03, 3.53), thyroid/musculoskeletal (HR, 1.90; 95% CI: 1.06, 3.39) and cardiometabolic (HR, 2.77; 95% CI: 1.40, 5.46) patterns exhibited with higher depression hazards, compared to those without 2+ diseases (multimorbidity). In the subsample of multimorbid individuals (85%), only the cardiometabolic pattern remained associated with a higher depression hazard compared to the unspecific pattern (HR, 1.71; 95% CI: 1.02, 2.84).

    Conclusions

    Both number and patterns of co-occurring somatic diseases are associated with an increased risk of late-life depression. Mental health should be closely monitored among older adults with high somatic burden, especially if affected by cardiometabolic multimorbidity.

  • Chapter 3 - Consultation-Liaison Psychiatry and Psychosomatics

  • Edited by Andrea Fiorillo, University of Campania “L. Vanvitelli”, Naples, Peter Falkai, Ludwig-Maximilians-Universität München, Philip Gorwood, Sainte-Anne Hospital, Paris
  • Book:
    Mental Health Research and Practice
    Published online:
    01 February 2024
    Print publication:
    08 February 2024, pp 27-48

  • Summary

    This chapter provides an overview concerning the historical development of consultation-liaison psychiatry (CLP) and details the meaning of consultation and liaison activity. The procedure of consultation is detailed. Several assessment tools that support clinical investigation are presented and discussed. Specifically, the assessment of personality traits, anxiety and depressive symptoms, and other psychological factors are addressed. As far as clinical research is considered, two topics are presented: CLP within the psycho-neuro-endocrine-immune perspective and CLP in the field of transplants. Finally, special attention is dedicated to the impact of CLP on health care budgets and to the role played by CLP in end-of-life care. Several skills are required in the field of CLP. Some are general (e.g., assessment of psychiatric diagnosis and medical-psychiatric comorbidity, use of psychopharmacological treatments, etc.); others are specific to the setting (e.g., transplantation, end-of-life-care, etc.). Once acquired, both general and specific skills may be implemented in psychiatric settings other than the CLP, thus representing professional assets potentially useful in all psychiatric settings. Therefore, CLP should be considered not only as a subspecialty of psychiatry, but also as a forma mentis, a professional attitude that the psychiatrist may implement in several psychiatric settings.

  • Chapter 25 - Psychiatric care at the end of life: hospice and palliative medicine

  • Edited by James J. Amos, University of Iowa, Robert G. Robinson, University of Iowa
  • Book:
    Psychosomatic Medicine
    Published online:
    04 August 2010
    Print publication:
    27 May 2010, pp 226-234

  • Summary

    Persons with access to medical care and combination antiretroviral medication (CART) are no longer dying of AIDS but are dying of other multimorbid and severe medical illnesses, as are comparable populations with HIV infection. AIDS psychiatry has become a subspecialty of psychosomatic medicine, similar to psychonephrology, psychooncology, and transplant psychiatry. Clinical decision-making in persons living with HIV and AIDS takes into account not only the multimorbid medical and psychiatric illnesses but also the need for prevention of HIV transmission and alleviation of the distress and suffering of persons infected and affected by the illness. This chapter discusses psychopharmacology and addictive disorders, and psychopharmacology and other psychiatric disorders. Psychosomatic medicine psychiatrists, AIDS psychiatrists, geriatric psychiatrists, child psychiatrists, other psychiatrists, and mental health clinicians can play a vital role in the prevention of HIV transmission and the care of persons with HIV.

  • “War neurosis” and associated physical conditions: an exploratory statistical analysis

  • Ian P Burges Watson, George V Wilson, Helen Hornsby
  • Journal:
    Irish Journal of Psychological Medicine / Volume 9 / Issue 1 / May 1992
    Published online by Cambridge University Press:
    13 June 2014, pp. 30-36
    Print publication:
    May 1992

  • Records of the war service disability claims for Australian Vietnam veterans in Tasmania (n = 751) were analysed to establish patterns of interrelationships between categories of disability. The predicted relationship between psychiatric disability and stress related skin disabilities was strongly supported and relationships between psychiatric and other medical disabilities were found. An exploratory principal components analysis produced three independent components which accounted for 21.2 percent of total variance. Component 1 was interpreted as a general military service component and components 2 and 3 were labelled as stress components. The most likely interpretation of the two stress components was that they reflect differences in profiles of records for disability claims depending on the time when the disability presented. The relevance of the findings is discussed.