Healthcare and preventive services utilization of elderly Europeans with depressive symptoms.
TL;DR: Share data suggest that patients with depressive symptoms are frequent users of healthcare but not preventive services, and low screening rates may reflect missed screening opportunities rather than a lack of screening opportunities.
About: This article is published in Journal of Affective Disorders.The article was published on 2008-01-01 and is currently open access. It has received 57 citations till now. The article focuses on the topics: Breast cancer screening.
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Dissertation•
01 Jan 2015
TL;DR: This paper is intended to serve as a “roadmap” for future generations of scientists and historians to consider the search for extraterrestrial intelligence during the period of World War II.
Abstract: ...................................................................................................................... 2 Acknowledgments ...................................................................................................... 4
18 citations
TL;DR: Most elderly with depressive symptoms received no medication for depression and being male, having no spouse and having a low schooling level are risk factors for depressive symptoms.
18 citations
Cites background or result from "Healthcare and preventive services ..."
...Depression is an important public health problem (Cassano and Fava, 2002; Duarte and Rego, 2007; Peytremann-Bridevaux et al., 2007) owing to its association to chronic diseases (Schnittker, 2005), cognitive impairment (Molaschi et al....
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...Depression is an important public health problem (Cassano and Fava, 2002; Duarte and Rego, 2007; Peytremann-Bridevaux et al., 2007) owing to its association to chronic diseases (Schnittker, 2005), cognitive impairment (Molaschi et al., 1998; Gallassi et al., 2001; Ponzetto et al., 2002),…...
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...Thus, in our study, we believe that access to services and health professionals by community elderly may explain the higher frequency of comorbidities found, compared to the institutionalized subjects (Peytremann-Bridevaux et al., 2007)....
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01 Jan 2009
17 citations
TL;DR: In this article, the authors explored factors associated with participation in a health screening exercise, using revealed preference, that is, actual attendance, to understand why people remain undiagnosed with chronic diseases.
Abstract: Background A large pool of patients with chronic diseases remains undiagnosed globally and in Singapore. We explored factors associated with participation in a health screening exercise, using revealed preference, that is, actual attendance, to understand why people remain undiagnosed with chronic diseases. Methods A cross-sectional, community-based sample of Singapore residents was invited to participate in home interviews, and subsequently to attend centre-based health screening, between 2004 and 2007. Determinants of health screening participation were identified using logistic regression models based on Andersen9s Behavioral Model. Results Of the 6366 participants who completed health interview, 4092 attended the health screening, while 2274 did not. Older age, Chinese or Indian ethnicity, higher education levels, greater intake of monounsaturated fat, greater transport and leisure-time physical activity were the key predisposing factors associated with greater health screening participation. Greater family cohesion was the key associated enabling factor, while previous diagnosis of dyslipidaemia or musculoskeletal conditions, absence of previously diagnosed diabetes or hypertension and lower perceived physical health were the associated need factors. Conclusions Our study suggests that ethnicity, education, family cohesion, healthy behaviour patterns and perceived physical health status were key determinants of health screening participation. Enhancing the cultural competence of preventive health services may help increase participation of these groups in screening efforts and reduce the proportions of undiagnosed chronic disease in the community.
17 citations
TL;DR: The phone interviews suggested that the Facebook group offered constant support, was simple to use, and provided the sole social support for many patients, and disliked repeated questions/spam and negative stories shared by some members.
Abstract: Social support after bariatric surgery is considered essential. Unfortunately, patient participation in such groups tends to be limited threatening their effectiveness. Facebook groups may provide a social support option that attracts more participation. The aim of this study was to describe our experience with the administration of a Facebook social support group and evaluate its perceived value by our bariatric patients. After IRB approval, all Facebook group posts since its establishment in 2015 were reviewed and a thematic analysis was undertaken. Group members also completed a survey related to their Facebook group experience and its perceived value. Responses were collected using 5-point Likert scales. In addition, 30 members were phone interviewed using open-ended questions and their responses were analyzed. Over 4 years, the group accumulated 12,507 posts, 104,053 comments, and 197,594 reactions. On average, members check the group page more than once per day. Ten common themes were identified in the submitted posts: questions, motivation related, education related, diet related, physical activity related, current status updates, sharing failures, social, random/humorous and other. Members reported that the group helped them do well with their procedure (3.3/5) particularly due to the motivation of others’ successful stories (3.5/5) and made them feel understood (3.9/5) even though it offered limited help controlling their eating habits (2.7/5). The phone interviews suggested that the Facebook group offered constant support, was simple to use, and provided the sole social support for many patients. They most appreciated the motivational posts that kept them on track and the assistance/comments of clinical staff. In contrast, they disliked repeated questions/spam and negative stories shared by some members. Facebook groups can provide effective social support to patients after bariatric surgery. Peers educate, answer questions, and motivate patients by sharing their positive experiences. Whether this online connectedness also positively impacts patient outcomes requires further study.
14 citations
References
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TL;DR: A systematic review of community-based studies of the prevalence of depression in later life (55+) found consistent evidence for higher prevalence rates for women and among older people living under adverse socio-economic circumstances.
Abstract: BACKGROUND Despite considerable interest, there is no consensus regarding the prevalence of depression in later life.
AIMS To assess the prevalence of late-life depression in the community.
METHOD A systematic review of community-based studies of the prevalence of depression in later life (55+). Literature was analysed by level of caseness at which depression was defined and measured.
RESULTS Thirty-four studies eligible for inclusion were found. The reported prevalence rates vary enormously (0.4-35%). Arranged according to level of caseness, major depression is relatively rare among the elderly (weighted average prevalence 1.8%), minor depression is more common (weighted average prevalence 9.8%), while all depressive syndromes deemed clinically relevant yield an average prevalence of 13.5%. There is consistent evidence for higher prevalence rates for women and among older people living under adverse socio-economic circumstances.
CONCLUSIONS Depression is common in later life. Methodological differences between studies preclude firm conclusions about cross-cultural and geographical variation. Improving the comparability of epidemiological research constitutes an important step forward.
1,087 citations
"Healthcare and preventive services ..." refers background in this paper
...In the elderly, the average prevalence of clinically relevant depressive syndromes (major and minor depression) is 13.5% (Beekman et al., 1999)....
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TL;DR: The authors conclude that physical disabilities among the elderly do not appear to be a major threat to the validity of the CES-D scale and that the strong associations between physical and mental health should be rigorously investigated.
Abstract: The associations between depressive symptoms and functional disability and chronic conditions are examined in an elderly cohort of 2,806 noninstitutionalized men and women living in New Haven, Connecticut who were interviewed in 1982 as a part of the Yale Health and Aging Project. The aim is to explore several potential sources of invalidity in using the Center for Epidemiologic Studies-Depression scale (CES-D) to measure depressive symptoms in elderly populations. In particular, the authors are concerned with the possibility that prevalent physical illnesses and disabilities may cause the older person to report many somatic complaints, a major component of most measures of depressive symptomatology, and thereby inflate his or her CES-D score. Mean CES-D scores are 4.86 for those without any disabilities and range to 13.51 for those with major functional disabilities. However, physical disability is significantly associated with virtually every item on the CES-D scale not just those somatically-oriented items. The addition of functional disability to a multivariate model including age subfactor analysis of responses from this elderly sample produces results almost identical to those reported by earlier investigators who studied younger and middle-aged adults. The authors conclude that physical disabilities among the elderly do not appear to be a major threat to the validity of the CES-D scale and that the strong associations between physical and mental health should be rigorously investigated.
805 citations
TL;DR: A two-factor solution seemed appropriate: depression, tearfulness and wishing to die loaded on the first factor (affective suffering), and loss of interest, poor concentration and lack of enjoyment on the second (motivation).
Abstract: BACKGROUND In an 11-country European collaboration, 14 population-based surveys included 21,724 subjects aged > or = 65 years. Most participating centres used the Geriatric Mental State (GMS), but other measures were also used.
AIMS To derive from these instruments a common depression symptoms scale, the EURO-D, to allow comparison of risk factor profiles between centres.
METHOD Common items were identified from the instruments. Algorithms for fitting items to GMS were derived by observation of item correspondence or expert opinion. The resulting 12-item scale was checked for internal consistency, criterion validity and uniformity of factor-analytic profile.
RESULTS The EURO-D is internally consistent, capturing the essence of its parent instrument. A two-factor solution seemed appropriate: depression, tearfulness and wishing to die loaded on the first factor (affective suffering), and loss of interest, poor concentration and lack of enjoyment on the second (motivation).
CONCLUSIONS The EURO-D scale should permit valid comparison of risk-factor associations between centres, even if between-centre variation remains difficult to attribute.
649 citations
"Healthcare and preventive services ..." refers methods in this paper
...The Survey of Health, Ageing, and Retirement in Europe (SHARE) [Börsch-Supan et al., 2005) included 10 countries in 2004 (Austria, Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden, and Switzerland)....
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...This was defined by a score N3 on the EURO-D, a validated instrument developed in Europe (Prince et al., 1999)....
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...Methods: Baseline self-reported data (2004) from non-institutionalized individuals aged ≥50 years participating in the Survey of Health, Ageing, and Retirement in Europe (SHARE) were used....
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...Twenty-eight percent of European men and women presented clinically significant depressive symptoms....
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...The SHARE data collection has been primarily funded by the European Commission through the 5th framework programme (project QLK6-CT-2001-00360 in the thematic programme Quality of Life)....
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TL;DR: The role of general medical practitioners in treating persons with psychiatric disorders is more limited than was anticipated and patients in categories associated with extensive use of professional care are more likely to have unmet care needs.
Abstract: OBJECTIVES: This study examined the use of primary health care, mental health care, and informal care services, as well as unmet care needs, by individuals with different psychiatric diagnoses. METHODS: Data were derived from the Netherlands Mental Health Survey and Incidence Study and were based on a representative sample (n = 7147) of the general population (aged 18-64 years). RESULTS: In a 12-month period, 33.9% of those with a psychiatric disorder used some form of care; 27.2% used primary care, and 15.3% used mental health care. Patients with mood disorders were the most likely to enlist professional care; those with alcohol- and drug-related disorders were the least likely to do so. Higher educated persons who live alone, single parents, unemployed persons, and disabled persons were more likely to use mental health care. Unmet need for professional help was reported by 16.8% (men 9.9%, women 23.9%) of those with a disorder. CONCLUSIONS: Care use varies widely by diagnostic category. The role of general medical practitioners in treating persons with psychiatric disorders is more limited than was anticipated. Patients in categories associated with extensive use of professional care are more likely to have unmet care needs.
372 citations
"Healthcare and preventive services ..." refers background in this paper
...Depressive symptoms are a major public health problem because of their high prevalence, their detrimental effect on health (Braam et al., 2005) and their association with relatively frequent use of medical services (Bijl and Ravelli, 2000; Huang et al., 2000)....
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..., 2005) and their association with relatively frequent use of medical services (Bijl and Ravelli, 2000; Huang et al., 2000)....
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TL;DR: Both major and minor depression are consequential for well-being and disability, supporting efforts to improve the recognition and treatment in primary care and underscoring the importance of recognition.
Abstract: Background. The consequences of major depression for disability, impaired well-being and service utilization have been studied primarily in younger adults. In all age groups the consequences of minor depression are virtually unknown. In later life, the increased co-morbidity with physical illness may modify the consequences of depression, warranting special study of the elderly. With rising numbers of elderly people, excess service utilization by depressed elderly represents an increasingly important issue. Methods. Based on a large, random community-based sample of older inhabitants of the Netherlands (55-85 years), the associations of major and minor depression with various indicators of disability, well-being and service utilization were assessed, controlling for potential confounding factors. Depression was diagnosed using a two-stage screening design. Diagnosis took place in all subjects with high depressive symptom levels and a random sample of those with low depressive symptom levels. The study sample consists of all participants to diagnostic interviews (N = 646). Results. As in younger adults, associations of both major and minor depression with disability and well-being remained significant after controlling for chronic disease and functional limitations. Adequate treatment is often not administered, even in subjects with major depression. As the vast majority of those depressed were recently seen by their general practitioners, treatment could have been provided in most cases. Bivariate analyses show that major and minor depression are associated with an excess use of non-mental health services, underscoring the importance of recognition. In multivariate analyses the evidence of excess service utilization was less compelling. Conclusions. Both major and minor depression are consequential for well-being and disability, supporting efforts to improve the recognition and treatment in primary care. However, controlled trials are necessary to assess the impact this may have on service utilization.
362 citations
"Healthcare and preventive services ..." refers result in this paper
...Concordant with previous population-based studies from several countries (Beekman et al., 1997; Fischer et al., 2002; Himelhoch et al., 2004; McCracken et al., 2006; Rowan et al., 2002), our results reveal an association between depressive symptoms and general healthcare use, which was not fully…...
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...Concordant with previous population-based studies from several countries (Beekman et al., 1997; Fischer et al., 2002; Himelhoch et al., 2004; McCracken et al., 2006; Rowan et al., 2002), our results reveal an association between depressive symptoms and general healthcare use, which was not fully explained by chronic diseases and/or disability....
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