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Depression among Elderly Residents of Local-Authority Residential Homes

Its Nature and the Efficacy of Intervention

Published online by Cambridge University Press:  02 January 2018

David Ames
David Ames*
Affiliation:
Department of Psychiatry, University of Melbourne, c/o PO Royal Melbourne Hospital, Victoria, 3050, Australia; Royal Free Hospital School of Medicine, Pond St, London NW3 2QG
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Abstract

Of 390 residents in 12 local-authority homes for the elderly, 93 had evidence of depression on screening and underwent standard clinical assessment. Half had an affective disorder, and a further third had depressive symptoms in the setting of an organic mental disorder. The 93 residents had a high rate of physical illness and disability, undertook little social activity, and were visited infrequently. A range of interventions for depressed residents, the majority social in type, mostly proved difficult to implement. There was no evidence of efficacy of psychiatric intervention at three months; at one-year follow-up a quarter of study participants had died, and 28% of those who were reassessed for depression showed evidence of recovery.

Type
Lecture
Information
The British Journal of Psychiatry , Volume 156 , Issue 5 , May 1990 , pp. 667 - 675
Copyright
Copyright © Royal College of Psychiatrists, 1990 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Ames, D., Ashby, D., Mann, A. H., et al (1988) Psychiatric illness in elderly residents of Part III homes in one London borough: prognosis and review. Age and Ageing, 17, 249–256.CrossRefGoogle ScholarPubMed
Baldwin, R. & Jolley, D. (1986) The prognosis of depression in old age. British Journal of Psychiatry, 149, 574–583.Google Scholar
Booth, T., Phillips, D., Barrit, A., et al (1983) Patterns of mortality in homes for the elderly. Age and Ageing, 12, 240–244.Google Scholar
Carstairs, V. & Morrison, M. (1971) The Elderly in Residential Care: Report of a Survey of Homes and their Residents. Scottish Health Care Studies, no. 19. Edinburgh: Scottish Home and Health Department.Google Scholar
Cohen, J. (1968) Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychology Bulletin, 70, 213–220.Google Scholar
Copeland, J. R. M., Kelleher, M. J., Kellet, J. M., et al (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State Schedule. 1. Development and reliability. Psychological Medicine, 6, 439–449.Google Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1986) Computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 89–99.Google Scholar
Day, P. & Klein, R. (1987) Quality of institutional care and the elderly: policy issues and options. British Medical Journal, 294, 384–387.CrossRefGoogle ScholarPubMed
Eastwood, M. & Corbin, S. (1986) The relationship between physical illness and depression in old age. In Affective Disorders in the Elderly (ed. Murphy, E.). Edinburgh: Churchill Livingstone.Google Scholar
Godlove, C., Richard, L. & Rodwell, G. (1982) Time for Action: An Observation Study of Elderly People in Four Different Care Environments. Sheffield: University of Sheffield.Google Scholar
Griffiths, R. (1988) Community Care: Agenda for Action. London: HMSO.Google Scholar
Gurland, B. J., Fleiss, J. L., Goldberg, K., et al (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State Schedule. 2. A factor analysis. Psychological Medicine, 6, 451–459.Google Scholar
Gurland, B. J., Kuriansky, J., Sharpe, L., et al (1977) The comprehensive assessment and referral evaluation (CARE) – rationale, development and reliability. International Journal of Aging and Human Development, 8, 9–42.Google Scholar
Gurland, B. J., Cross, P., DeFiguerido, J., et al (1979) A cross-national comparison of the institutionalized elderly in the cities of New York and London. Psychological Medicine, 9, 781–788.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296.CrossRefGoogle ScholarPubMed
Hirsch, S. (1982) Depression revealed in schizophrenia. British Journal of Psychiatry, 140, 421–423.Google Scholar
Katz, S. & Akfom, A. (1976) A measure of socio-biological functions (A.D.L.). International Journal of Health Services, 6, 493–507.CrossRefGoogle Scholar
Kendell, R. E. (1981) The present status of electroconvulsive therapy. British Journal of Psychiatry, 139, 265–283.CrossRefGoogle ScholarPubMed
Lau-Ting, C., Ting, T. & Phoon, W. (1987) Mental status of residents in old people's homes. Annals of Academic Medicine of Singapore, 16, 118–121.Google ScholarPubMed
Lowther, C. & McLeod, H. (1974) Admissions to a welfare home. Health Bulletin, 32, 14–18.Google Scholar
MacDonald, A. J. D., Mann, A. H., Jenkins, R., et al (1982) An attempt to determine the impact of four types of care upon the elderly in London by the study of matched groups. Psychological Medicine, 12, 193–200.CrossRefGoogle Scholar
Magni, G., Palazzolo, O. & Bianchin, G. (1988) The course of depression in elderly outpatients. Canadian Journal of Psychiatry, 33, 21–24.Google Scholar
Mann, A. H., Graham, N. & Ashby, D. (1984a) Psychiatric illness in residential homes for the elderly: a survey in one London borough. Age and Ageing, 13, 257–265.Google Scholar
Mann, A. H., Wood, K., Cross, P., et al (1984b) Institutional care of the elderly: a comparison of the cities of New York, London and Mannheim. Social Psychiatry, 19, 97–102.Google Scholar
Mann, A. H., Ames, D., Graham, N., et al (1989) The reliability of the Brief Assessment Schedule. International Journal of Geriatric Psychiatry, 4, 221–225.Google Scholar
Medical Research Council (1965) Clinical trial of the treatment of depressive illness. British Medical Journal, i, 881–886.Google Scholar
Ministry of Health (1948) Annual Report. London: HMSO.Google Scholar
Murphy, E. (1983) The prognosis of depression in old age. British Journal of Psychiatry, 142, 111–119.Google Scholar
Murphy, E. (1986) Social factors in late life depression. In Affective Disorders in the Elderly (ed. Murphy, E.). Edinburgh: Churchill Livingstone.Google Scholar
Pitt, B. (1986) Characteristics of depression in the elderly. In Affective Disorders in the Elderly (ed. Murphy, E.). Edinburgh: Churchill Livingstone.Google Scholar
Post, F. (1972) The management and nature of depressive illness in late life: a follow through study. British Journal of Psychiatry, 112, 393–404.Google Scholar
Snowdon, J. (1986) Dementia, depression and life satisfaction in nursing homes. International Journal of Geriatric Psychiatry, 1, 85–91.Google Scholar
Southwark Council (1987) Report of the Inquiry into Nye Bevan Lodge. London: Southwark Social Services.Google Scholar
Spagnoli, A., Foresti, G., MacDonald, A. J. D., et al (1986) Dementia and depression in Italian geriatric institutions. International Journal of Geriatric Psychiatry, 1, 15–23.CrossRefGoogle Scholar
Swartz, M. & Blazer, D. (1986) The distribution of affective disorders in old age. In Affective Disorders in the Elderly (ed. Murphy, E.). Edinburgh: Churchill Livingstone.Google Scholar
Tarbox, A. (1983) The elderly in nursing homes: psychological aspects of neglect. Clinical Gerontologist, 1, 39–52.CrossRefGoogle ScholarPubMed
Teeter, R., Garetz, F., Miller, W., et al (1976) Psychiatric disturbances of aged patients in skilled nursing homes. American Journal of Psychiatry, 133, 1430–1434.Google Scholar
Wilkin, D., Mashiah, T. & Jolley, D. (1978) Changes in the behavioural characteristics of the elderly population in local authority homes and long stay hospitals, 1976–77. British Medical Journal, ii, 1274–1276.Google Scholar
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