Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-23T12:59:24.180Z Has data issue: false hasContentIssue false
  • English
  • Français

Les psychotropes et le vieillissement normal: une perspective psychosociale et socio-économique*

Published online by Cambridge University Press:  29 November 2010

Guilhème Pérodeau ,
Adèle Jomphe Hill ,
Lisette Hay-Paquin  and
Élise Amyot
Guilhème Pérodeau
Affiliation:
Université du Québec à Hull
Adèle Jomphe Hill
Affiliation:
Université du Québec à Hull
Lisette Hay-Paquin
Affiliation:
Université du Québec à Hull
Élise Amyot
Affiliation:
Université du Québec à Hull
Get access Rights & Permissions [Opens in a new window]

Abstract

The goal of this study was to examine the reaction (anxiety, depression, and helplessness) and adaptive strategies (problem-solving and emotion-reducing) of community-dwelling elderly, confronted by one specific chronic stressor. We have conducted three face-to-face home interviews on a monthly basis with a follow-up interview seven months later. There were 237 psychotropic drug users and non-users, of high or low socio-economic status. Not only were low socio-economic psychotropic drug users more anxious about the targeted hassle of the week, but they also relied on and used more problem-solving strategies than non-drug users. It is suggested that psychotropic drug use be looked at as a strategy like any others rather than as passive behaviour when facing daily hassles. Moreover, using a high number of coping strategies is not synonymous with being good at coping with chronic stress. Various recommandations for clinical intervention are put forward.

Résumé

L'objectif de cette étude était d'examiner la réaction (sentiment d'anxiété, de dépression et d'impuissance) et les stratégies d'adaptation (résolution de problème et réduction d'émotion) de personnes âgées, vivant à domicile, face à un stresseur chronique. Nous avons mené trois entrevues en face à face, à domicile et sur une base mensuelle pendant trois mois avec un suivi sept mois plus tard auprès de 237 participants, consommateurs ou non de psychotropes, de niveau socio-économique bas ou élevé. Bien que plus anxieux face au tracas-cible de la semaine, les consommateurs en milieu défavorisé utilisaient un plus grand nombre de stratégies de résolution de problème et de façon plus fréquente que les non-consommateurs. L'utilisation de psychotropes doit done être vue comme une stratégie parmi dapos;òt qu'une indication de passivité généralisée face aux stresseurs du quotidien. Toutefois un plus grand nombre de stratégies n est pas nécessairement synonyme d efficacité. Diverses recommandations pour l'intervention sont mises de l'avant.

Keywords

Stressstratégies d'adaptationutilisation de psychotropessanté mentale.StressCopingPsychotropic Drug UseMental Health.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 15 , Issue 4 , Hiver/Winter 1996 , pp. 559 - 582
Copyright
Copyright © Canadian Association on Gerontology 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Réferencés

Armstrong, D., Bird, J., Fry, J., & Armstrong, P. (1992). Perceptions of psychological problems in general practice: a comparison of general practitioners and psychiatrists. Family Practice, 9(2), 173–176.Google ScholarPubMed
Bergin, B., & Baron, J. (1995). Les ainés et la toxicomanie. L'Infirmière Canadienne, 39–43.Google Scholar
Burns, B., & Phillipson, C. (1986). Drugs, ageing, and society: social and pharmacological perspectives. London: Croom Helm.Google Scholar
Campbell, A.J. (1991). Drug treatment as a cause of falls in old age. A review of the offending agents. Drugs and Aging, 1(4), 289–302.CrossRefGoogle ScholarPubMed
Charles, I., & Daniel, M.C. (1990). Médicaments et personnes âgées. Revue de L'lnfirmière, 1, 37–41.Google Scholar
Cormier, D., & Trudel, J. (1986). Pilules mirages: essai sur la qualité de vie des aînées. Québec: Association des centres d'accueil du Québec.Google Scholar
DeLongis, A., Coyne, J.C., Dakof, G., Folkman, S., & Lazarus, R.S. (1982). Relationships of daily hassles, uplifts, and major life events to health status. Health Psychology, 1(2), 119–136.CrossRefGoogle Scholar
Derogatis, L.R., Lipman, R.S., Rickels, K., Uhlenhuth, E.H., & Covi, L. (1974). The Hopkins Symptom Checklist: A self-report inventory. Behavioral Science, 19, 1–15.CrossRefGoogle Scholar
Fogel, B.S., & Fretwell, M.D. (1991). Common mental heath problems in geriatric practice. Part I: Dementia, depression, anxiety, and prescription drug toxicity. Rhode Island Medical Journal, 74(2), 62–67.Google Scholar
Folkman, S., Bernstein, L., & Lazarus, R. (1987). Stress process and the misuse of drugs in older adults. Psychology and Aging, 2(4), 366–374.CrossRefGoogle ScholarPubMed
Folkman, S., Lazarus, R.S., Gruen, R.J., & DeLongis, A. (1986). Appraisal, coping, health status, and psychological symptoms. Journal of Personality and Social Psychology, 50(3), 571–579.CrossRefGoogle ScholarPubMed
Glantz, M. (1981). Prediction of elderly drug abuse. Journal of Psychoactive Drugs, 13(2), 117–126.Google ScholarPubMed
Good, B.J., & Delvecchio-Good, M.J. (1981). The meaning of symptoms: A cultural hermeneutic model for clinical practice. Eisenberg, Dans L. & Kleinman, A. (Éds.), The Relevance of social science for medicine (pp. 165–196). New York: D. Reidel Publishing Company.CrossRefGoogle Scholar
Gouvernement du Québec. (1995). L'utilisation rationnelle des médicaments ehez lespersonnes âgées: Stratégies d'action. Québec: Ministère de la Santé et des Services sociaux.Google Scholar
Helman, C.G. (1985). Psyche, soma, and society: The social construction of psychosomatic disorders. Culture, Medicine, and Psychiatry, 9(1), 1–26.Google Scholar
Holahan, C, & Moos, R.H. (1987). Personal and contextual determinants of coping strategies. Journal of Personality and Social Psychology, 52, 946–955.CrossRefGoogle ScholarPubMed
Isacson, D., & Haglund, B. (1988). Psychotropic drug use in a Swedish community — the importance of demographic and socio-economic factors. Social Science and Medicine, 26(A), 477–483.CrossRefGoogle Scholar
Jones, D. (1992). Characteristic of elderly people taking psychotropic medication. Drugs and Aging, 2(5), 389–394.Google ScholarPubMed
Kanner, A.D., Coyne, J.C., Schaeffer, C, & Lazarus, R.S. (1981). Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events. Journal of Behavioral Medicine, 4(1), 1–39.Google ScholarPubMed
Kelly, L.E., Knox, J., & Gekoski, W.L. (1994). Assessing locus of control of reinforcement in elderly people: Evaluation of the desired control measure. La Revue canadienne du vieillissement, 13(3), 318–331.CrossRefGoogle Scholar
Laurier, C, Dumas, J., Grégoire, J., & Duval, L. (1990). L'utilisation des tranquillisants, sédatifs et somnifères: analyse des données de l'enquëte santé Québec. Québec: Gouvernement du Québec.Google Scholar
Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.Google Scholar
Lexchin, J. (1990a). Drug makers and drug regulators: Too close for comfort. A study of the Canadian situation. Social Science and Medicine, 31(11), 1257–1264.CrossRefGoogle Scholar
Lexchin, J. (1990b). The portrayal of the elderly in drug advertisements: a factor in inappropriate prescribing? La Revue canadienne du vieillissement, 9(3), 296–303.CrossRefGoogle Scholar
Mayer-Renaud, M. (1986). Distribution de la pauvreté et de la richesse dans les regions urbaines du Québec. Portrait de la région de Montréal. Montréal: Centre des services sociaux du Montréal Métropolitain.Google Scholar
McCrae, R.R. (1984). Situational determinants of coping response: Loss threat and challenge. Journal of Personality and Social Psychology, 46, 919–928.CrossRefGoogle ScholarPubMed
Nezu, A.M., & Ronan, G.F. (1985). Life stress, current problems, problem solving, and depressive symptoms:an integration model. Journal of Consulting and Clinical Psychology, 53, 693–697.CrossRefGoogle Scholar
North, D.A., McAvoy, B.R., & Powell, A.M. (1992). Benzodiazepine use in general practice-is it a problem? New Zealand Medical Journal, 205(938), 287–289.Google Scholar
Olivier, C. (1992). Les médicaments: oui … non … mais. Hull: Direction générale de la santé publique de l'Outaouais.Google Scholar
Pérodeau, G.M., & Ostoj, M. (1992). Stress et strategic d'adaptation des personnes âgées. Québec: Conseil Québécois de la Recherche Sociale.Google Scholar
Pérodeau, G.M., Poirier, S., Foisy, P., & Ostoj, M. (1992). Drug interactions among the elderly in a home care program. Journal of Geriatric Drug Therapy, 6(3), 41–60.Google Scholar
Plante, M.A. (1989). La consommation de psychotropes par la population âgée de la région des Laurentides. Saint-Jérôme: Département de santé communautaire.Google Scholar
Québec. Ministère de la Santé et des Services sociaux. (1994). Colloque sur l'utilisation rationnelle des médicaments chez les personnes âgées. Québec: Ministère de la Santé et des Services sociaux.Google Scholar
Radloff, L. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Ray, W.A. (1992). Psychotropic drugs and injuries among the elderly: a review. Journal of Clinical Psychopharmacology, 12(6), 386–396.CrossRefGoogle ScholarPubMed
Reid, D.W., & Ziegler, M. (1981). The desired control measure and adjustment among the elderly. Lefcourt, Dans H.M. (éd.), Advances and Innovations in the Locus of Control Research (pp. 127–159). New York: Academic Press.Google Scholar
Rickels, K. (1986). The clinical use of hypnotics: indications for use and the need for a variety of hypnotics. Acta Psychiatrics Scandinavia, 74(332), 132–141.CrossRefGoogle Scholar
Santé et Bien-être social Canada. (1981). Statistiques Canada. La santé des canadiens. Rapport de l'enquête Santé Canada. Ottawa: Statistiques Canada.Google Scholar
Steiner, D., & Marcopulos, B. (1991). Depression in the elderly. Characteristics and clinical management. Nursing clinics of North America, 26(3), 585–600.CrossRefGoogle ScholarPubMed
Stevens, J. (1986). Applied multivariate statistics for the Social Science. London: Lawrence Erlbaum Associates.Google Scholar
Tamblyn, R.M., Mcleod, P.J., Abrahmowicz, M. &, Monette, J., Gayton, D.C., Berkson, L., Dauphinee, W.D., Grad, R.M., Huang, A.R., Isaac, L.M., Schnarch, B.S., & Snell, L.S. (1994). Questionable prescribing for elderly patients in Quebec. Canadian Medical Association Journal, 250(11), 1801–1809Google Scholar
Tennant, C., Bebbington, P., & Hurry, J. (1981). The role of life events in depressive illness:is there substantial causal relation? Psychological Medecine: A Journal for Research in Psychiatry and the Allied Sciences, 11, 379–389.CrossRefGoogle ScholarPubMed
Vezina, J., & Giroux, L. (1988). L'échelle des embêtements: la validation française du Hassles Scale pour les personnes âgées (miméo).Google Scholar
Weyerer, S., & Dilling, H. (1991). Psychiatric and physical illness, sociodemographic characteristics, and the use of psychotropic drugs in the community: Results from the Upper Bavarian Field Study. Journal of Clinical Epidemiology, 44(3), 303–311.CrossRefGoogle ScholarPubMed
Wise, M.G., & Tierney, J. (1992). Psychopharmacology in the elderly. Journal of the Louisiana State Medical Society, 144(10), 471–176.Google ScholarPubMed