Background: Except for dementia and depression, little is known about common mental disorders in elderly people.Aims: To estimate current, 12-month and lifetime prevalence rates of mental disorders in different European and associated countries using a standardised diagnostic interview adapted to measure the cognitive needs of elderly people.Method: The MentDis_ICF65+ study is based on an age-stratified, random sample of 3142 older men and women (65–84 years) living in selected catchment community areas of participating countries.Results: One in two individuals had experienced a mental disorder in their lifetime, one in three within the past year and nearly one in four currently had a mental disorder. The most prevalent disorders were anxiety disorders, followed by affective and substance-related disorders.Conclusions: Compared with previous studies we found substantially higher prevalence rates for most mental disorders. These findings underscore the need for improving diagnostic assessments adapted to the cognitive capacity of elderly people. There is a need to raise awareness of psychosocial problems in elderly people and to deliver high-quality mental health services to these individuals.
Background: Despite the widespread application of Symptom Checklist 90-R (SCL-90-R), its psychometric weaknesses have repeatedly been noted. This study aimed to comparatively assess the psychometric properties of the SCL-90-R scales and the scales of its short versions Brief Symptom Inventory (BSI), Symptom Checklist-27 (SCL-27), Brief Symptom Inventory-18 (BSI-18), Symptom Checklist-14 (SCL-14), and Symptom Checklist short version-9 (SCL-K-9) in patients with affective disorders. Methods: The data of 2,727 patients within the main treatment group of affective disorders were assessed according to the DSM-IV. Patients completed the SCL-90-R and Beck Depression Inventory (BDI). Results: There were no significant differences regarding the internal consistency of the SCL-90-R scales and the scales of the short versions. The dimensional structure was only supported for the short versions BSI-18, SCL-14 and SCL-K-9. The assessment of convergent validity revealed high correlations. With regard to the discriminant validity, there were medium correlations. With regard to the sensitivity of change, no significant differences between the scales were found. Conclusions: In summary, the scales of the short versions show mostly satisfactory psychometric properties in comparison to the scales of the SCL-90-R. The results support the application of the short versions as screening instruments, especially the BSI-18, and more economic variants of the SCL-90-R covering a wide range of psychopathological symptoms.
The purpose of this study was to develop and validate a self-rating scale for a differentiated assessment of mentalization. A pool of 40 items was developed and evaluated on n=434 inpatients with mental disorders at three time points. Symptom severity, self-injuring behavior, suicidal tendency and attachment style were also assessed. A varimax-rotated factor analysis supported the extraction of four factors. The model fit was checked by confirmatory factor analysis. Internal consistency of the Mentalization Questionnaire (MZQ) was .81. The relation between symptom severity and MZQ scores was found to be significant, and significant group differences were found between patients displaying self-injuring behavior and those who did not as well as between patients with and without suicide attempts. The MZQ can be considered as a practicable self-rated instrument with acceptable reliability and sufficient validity to assess at least aspects of mentalization in patients with mental disorders.
1 February 2018 in The American Journal of Geriatric Psychiatry
Previous estimates of the prevalence of anxiety disorders in late life vary greatly due to the lack of reliable diagnostic tools. This MentDis_ICF65+ study assessed 12-month prevalence rates of anxiety disorders and age- and gender-related differences in comorbidities, as well as impact on quality of life. The study used a cross-sectional multicenter survey. The study sample comprised 3,142 men and women aged 65 to 84 years, living in five European countries and Israel. Anxiety disorders were assessed using computer-assisted face-to-face interviews with an age-appropriate diagnostic interview (CIDI65+). The prevalence of anxiety disorders was 17.2%. Agoraphobia was the most frequent disorder (4.9%), followed by panic disorder (3.8%), animal phobia (3.5%), general anxiety disorder (3.1%), post-traumatic stress disorder (1.4%), social phobia (1.3%), and obsessive-compulsive disorder (0.8%). The prevalence rate of any anxiety disorder dropped by 40% to 47% in adults aged 75-84 years compared with those aged 65-74 years. Women were twice as likely to present with agoraphobia or general anxiety disorder as men. Only panic disorder and phobia were associated with comorbid major depression. The negative relationship with quality of life was limited to agoraphobia and generalized anxiety disorder. The age-appropriate CIDI65+ led to higher prevalence rates of anxiety disorders in the elderly, yet to weaker associations with comorbidities and impaired quality of life compared with previous studies.
There is a relative lack of current research on the effects of specific communication training offered at the beginning of the medical degree program. The newly developed communication training "Basics and Practice in Communication Skills" was pilot tested in 2008 and expanded in the following year at the University Medical Centre Hamburg-Eppendorf in Germany. The goal was to promote and improve the communicative skills of participants and show the usefulness of an early offered intervention on patient-physician communication within the medical curriculum.