Search

Social media may have the double potential to support and undermine mental health, and research is needed to investigate these relationships in age-specified populations. The purpose of this study was to investigate associations between the use of social media and psychological distress among older adults (60 years and above) both nine and 19 months after the outbreak of the COVID-19 pandemic. An online repeated cross-sectional survey was conducted in Australia, Norway, the United Kingdom, and the United States. Participants (9 months: n = 679; 19 months: n = 238) reported the extent of social media use, motives for using social media, and level of psychological distress using the 12-item version of the General Health Questionnaire (GHQ-12). The data were analysed with descriptive analyses, independent t-tests and multiple linear regression analyses. Time spent on social media was not associated with psychological distress. Higher psychological distress was associated with higher scores on using social media to 'reduce loneliness' at both measurement points. At nine months, higher psychological distress was associated with higher scores on using social media for 'entertainment', but the association was not statistically significant at 19 months. Psychological distress was associated with the motive to 'maintain relationships' at 19 months, but not at nine months. Guidance for older adults' use of social media should emphasise how they can be used to promote communication and maintain existing relationships. [ABSTRACT FROM AUTHOR]

Background: Depression is common in old age and is associated with disability, increased mortality, and impairment from physical diseases. Aim: To estimate the prevalence of depression among older patients in Norwegian general practice, to evaluate the extent they talk about it during their consultation, whether it was previously known or suspected by their GP, and how frequently patients with depression visit their GP. Design & setting: Cross-sectional study among patients and GPs at 18 primary care clinics in the south of Norway. Method: Patients aged ≥65 years who visited their GP were asked to complete the Patient Health Questionnaire-9 (PHQ-9). The GPs reported what kind of issues the patient presented at the consultation, if a current depression was known, and the consultation frequency. Results: Forty-four (11.4%) of 383 patients reported moderate or severe depressive symptoms (PHQ9 ≥10). Among the cases with data from both patient and GP (n = 369), 38 patients (10.3%) reported moderately depressive symptoms. Of these, only 12 (31.6%) mentioned psychological problems to their GP during their consultation; 12 (31.6%) with previous depression were neither known to the GP nor suspected of currently having depression; and 67.6% of them visited their GP ≥5 times a year. Conclusion: Older patients tend to speak little of their depression to the GP. Almost one in three older patients with moderate depressive symptoms were unrecognised by their GP. Older patients who frequently visit the GP should be suspected of potentially having mental health problems. [ABSTRACT FROM AUTHOR]

Background: Elderly patients with depression are underdiagnosed, undertreated and run a high risk of a chronic course. General practitioners adhere to clinical practice guidelines to a limited degree. In the international research project Tailored Implementation for Chronic Diseases, we tested the effectiveness of tailored interventions to improve care for patients with chronic diseases. In Norway, we examined this approach to improve adherence to six guideline recommendations for elderly patients with depression targeting healthcare professionals, patients and administrators.Methods: We conducted a cluster randomised trial in 80 Norwegian municipalities. We identified determinants of practice for six recommendations and subsequently tailored interventions to address these determinants. The interventions targeted healthcare professionals, administrators and patients and consisted of outreach visits, a website presenting the recommendations and the underlying evidence, tools to manage depression in the elderly and other web-based resources, including a continuous medical education course for general practitioners. The primary outcome was mean adherence to the recommendations. Secondary outcomes were improvement in depression symptoms as measured by patients and general practitioners. We offered outreach visits to all general practitioners and practice staff in the intervention municipalities. We used electronic software that extracted eligible patients from the general practitioners' lists. We collected data by interviewing general practitioners or sending them a questionnaire about their practice for four patients on their list and by sending a questionnaire to the patients.Results: One hundred twenty-four of the 900 general practitioners (14 %) participated in the data collection, 51 in the intervention group and 73 in the control group. We interviewed 77 general practitioners, 47 general practitioners completed the questionnaire, and 134 patients responded to the questionnaire. Amongst the general practitioners who provided data, adherence to the recommendations was 1.6 percentage points higher in the intervention group than in the control group (95 % CI -6 to 9).Conclusions: The effectiveness of our tailored intervention to implement recommendations for elderly patients with depression in primary care is uncertain, due to the low response rate in the data collection. However, it is unlikely that the effect was large. It remains uncertain how best to improve adherence to evidence-based recommendations and thereby improve the quality of care for these patients.Trial Registration: ClinicalTrials.gov: NCT01913236 . [ABSTRACT FROM AUTHOR]

Background Family caregivers of patients with psychiatric or medical disorders are at risk of developing psychological distress. Studies including family caregivers of patients with dementia have shown that psychoeducative programmes reduce distress and postpone institutionalisation. Little is known about the effect of psychoeducation of relatives of psychogeriatric patients. The aim of this study was to investigate the effect of a single-session educational intervention of relatives of psychogeriatric in-patients. Methods A randomised controlled intervention study was carried out with 16 relatives in the intervention group and 14 in the control group. The intervention was carried out as a single session programme. Primary outcome measures were psychological well-being and depression as measured by means of General Health Questionnaire (GHQ-30), Impact of Event Scale (IES) and Geriatric Depression Scale (GDS). Outcome measures were performed at baseline, at discharge and at 3-month follow-up. Results Psychological distress was high. Daughters were more depressed and distressed than spouses. Patients' diagnoses did not seem to exert influence on the relatives' well-being. There was a significant worsening of psychological distress in the intervention group as measured by GHQ-30. Conclusions The study is small and results must be interpreted with caution. Distress among relatives was high regardless of patient's diagnosis. The results of the intervention might lead us to conclude that single-session interventions towards this specific group of relatives do not improve psychological stress and might, in some aspects, even worsen it. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: The course of COVID-19 may be particularly long-lasting in elderly patients. Caring for patients with dementia suffering from COVID-19 is challenging due to unclear symptom presentation, delirium, and maintaining isolation procedures., Case Presentation: A man in his sixties with dementia, hospitalised in a psychogeriatric ward, presented with mild upper respiratory tract symptoms and recovered within 24 hours. Ten days later he developed more severe symptoms. PCR test for SARS-CoV-2 was positive. Over the following two months his clinical state fluctuated, from almost symptom-free days to being bedridden and assessed as potentially terminal. After the initial positive test, he had three consecutive negative tests, before he again tested positive for SARS-CoV-2. Uncertainty as to whether the patient remained contagious resulted in isolation of the patient for over two months., Interpretation: PCR testing of SARS-CoV-2 does not differentiate between intact virus and remnants thereof, and patients may test positive for a long time. This along with a fluctuating clinical course makes it difficult for clinicians to decide when to end isolation of COVID-19 patients.