[Psychiatric Consultations for Nursing-Home Residents: Aspects and Course of Such Consultations].

[Psychiatric consultations for nursing-home residents: aspects and course of such consultations].

Filed under: Depression Treatment

Tijdschr Psychiatr. 2012; 54(10): 853-60
Steenbeek M, van Baarsen C, Koekkoek B

background Psychiatric symptoms occur frequently in nursing-home residents. The psychiatric expertise and support available to residents vary from one nursing home to another. International studies show that psychiatric consultations can be effective, but in the Netherlands very little research has been done on this topic. aim To list the types of psychiatric problems and symptoms for which consultations are requested and to determine whether a psychiatric consultation can have positive results for nursing-home residents and staff. method The psychiatric consultations requested were tabulated and were analysed. results Details of 71 psychiatric consultations were recorded. The percentage of women (average age 74 years) was slightly higher than the percentage of men. More than 75% of the patients suffered from agitation/aggression or irritability, 65% suffered from depression, 63% from anxiety and 56% from dysinhibition. A post-intervention assessment was performed in 54 patients (76%). In this group psychiatric symptoms were found to be greatly reduced, with regard to both frequency and severity. In addition, nursing staff seemed to suffer less of the stress and strain in their work. conclusion The patients for whom a consultation was requested seemed to suffer from serious psychiatric symptoms and were often aggressive. It was possible to achieve substantial progress as a result of a simple intervention. A possible explanation for this effect is probably the nature of the psychiatric consultation used; it was structured, multi-disciplinary and time-consuming. However, since no control group was involved, it is impossible to say with certainty that the reduction in symptoms can be attributed solely to the consultation.
HubMed – depression


Rumination Moderates the Associations Between PTSD and Depressive Symptoms and Risky Behaviors in U. S. Veterans.

Filed under: Depression Treatment

J Trauma Stress. 2012 Oct; 25(5): 583-6
Borders A, McAndrew LM, Quigley KS, Chandler HK

Risky behaviors, including unsafe sex, aggression, rule breaking, self-injury, and dangerous substance use have become a growing issue for U.S. veterans returning from combat deployments. Evidence in nonveteran samples suggests that risky behaviors reflect efforts to cope with and alleviate depressive and/or anxious symptoms, particularly for individuals with poor emotion-regulation skills. These associations have not been studied in veterans. Rumination, or repeated thoughts about negative feelings and past events, is a coping strategy that is associated with several psychopathologies common in veterans. In this cross-sectional study, 91 recently returned veterans completed measures of trait rumination, self-reported risky behaviors, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses revealed that veterans with more depressive and PTSD symptoms reported more risky behaviors. Moreover, rumination significantly interacted with PTSD symptoms and depressive symptoms (both ? = .21, p < .05), such that psychiatric symptoms were associated with risky behaviors only for veterans with moderate to high levels of rumination. Although cross-sectional, these findings support theory that individuals with poor coping skills may be particularly likely to respond to negative mood states by engaging in risky behaviors. Implications include using rumination-focused interventions with veterans in order to prevent engagement in risky behaviors. HubMed – depression


Modeling PTSD Symptom Clusters, Alcohol Misuse, Anger, and Depression as They Relate to Aggression and Suicidality in Returning U.S. Veterans.

Filed under: Depression Treatment

J Trauma Stress. 2012 Oct; 25(5): 527-34
Hellmuth JC, Stappenbeck CA, Hoerster KD, Jakupcak M

Suicidal ideation and aggression are common correlates of posttraumatic stress disorder (PTSD) among U.S. Iraq and Afghanistan war veterans. The existing literature has established a strong link between these factors, but a more nuanced understanding of how PTSD influences them is needed. The current study examined the direct and indirect relationships between PTSD symptom clusters and suicidal ideation in general aggression (without a specified target) regarding depression, alcohol misuse, and trait anger. Participants were 359 (92% male) U.S. Iraq/Afghanistan war veterans. Path analysis results suggested that the PTSD numbing cluster was directly (? = .28, p < .01) and indirectly (? = .17, p = .001) related through depression. The PTSD hyperarousal cluster was indirectly related to suicidal ideation through depression (? = .13, p < .001). The PTSD reexperiencing cluster was directly related to aggression (? = .17, p < .05), whereas the PTSD numbing and hyperarousal clusters were indirectly related to aggression through trait anger (? = .05, p < .05; ? = .20, p < .001). These findings indicate that adjunct treatments aimed at stabilizing anger, depression, and alcohol misuse may help clinicians ameliorate the maladaptive patterns often observed in veterans. These results also point to specific manifestations of PTSD and co-occurring conditions that may inform clinicians in their attempts to identify at risk veterans and facilitate preventative interventions. HubMed – depression


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