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How is depression in the elderly patient diagnosed?
- R. Fernández Fernández, Á. Izquierdo de la Puente, P. del Sol Calderón, O. Méndez González
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S942
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Introduction
The diagnosis of depression in the elderly patient presents peculiarities that should be taken into account. Studies point out the importance of an adequate screening of suspected cases of depression in older adults by physical therapists and other non-mental health professionals (Ramos Vieira et al., 2014). In this study, we intend to find out which are the most used diagnostic methods in Mental Health research on geriatric patient.
ObjectivesTo analyze the diagnostic methods most used in research on the geriatric patient, specifically in articles that analyze the patient with cognitive impairment.
MethodsA bibliographic search of all articles analyzing depression in patients with cognitive impairment between 2000 and 2020 was carried out. The diagnostic method of depression in each of them has been collected.
ResultsA total of 38 studies were analyzed. The most common diagnostic method continues to be the use of diagnostic criteria (ICD or DSM), which is used in 34.2% of the studies, while the Center for Epidemiologic Studies Depression Scale (CES-D) is the most commonly used test, appearing in 23.7% of the studies. The remaining tests (CIDI, GDS, HAM17, PHQ, SCID, SCL-90, SGDS) do not reach 10% each.
Counts % of Total Cumulative % GDS 2 5.3 % 5.3 % CES-D 9 23.7 % 28.9 % CIDI 2 5.3 % 34.2 % Diagnostic criteria 13 34.2 % 68.4 % EURO-D 1 2.6 % 71.1 % PHQ 2 5.3 % 76.3 % GMS-AGECTA 2 5.3 % 81.6 % HAM-17 1 2.6 % 84.2 % Others 6 15.8 % 100 % ConclusionsThe diagnosis of depression continues to be made primarily using diagnostic criteria. It is striking that the most commonly used test is the CES-D, given that the Geriatric Depression Scale (GDS) is usually the most popular scale for screening for late-life depression (Gana et al., 2017), which may be due to the fact that the studies analyzed have a more research than clinical purpose.
ReferencesGana, K., Bailly, N., Broc, G., Cazauvieilh, C., & Boudouda, N. E. (2017). The Geriatric Depression Scale: does it measure depressive mood, depressive affect, or both?. International journal of geriatric psychiatry, 32(10), 1150–1157.
Vieira, E. R., Brown, E., & Raue, P. (2014). Depression in older adults: screening and referral. Journal of geriatric physical therapy (2001), 37(1), 24–30.
Disclosure of InterestNone Declared
Case Report Klinefelter Syndrome and Multiple Sclerosis as the Cause of Psychosis
- A. Rodriguez Rodriguez, R. Blanco Fernández, M. Vizcaino da Silva, R. Fernández Fernández, O. Mendez Gonzalez
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S638
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Introduction and goals
Forty-three-year-old male diagnosed with Klinefelter syndrome and showing radiological findings suggesting a demyelinating pathology who presents several psychiatric manifestations including megalomaniacal ideation, delusion, lack of impulse control and behavioral alterations.
Clinical caseForty-three-year-old male diagnosed with Klinefelter syndrome at the age of 31, presenting several psychiatric pathologies since adolescence: delusions, megalomania, mood fluctuation, and high impulsiveness. The patient had a poor therapeutic response to anti-psychotic drugs and ECT. He was hospitalized up to 9 times, but the full control of the symptomatology was not achieved. During his last hospitalization, a MRI revealed lesions compatible with a demyelinating pathology.
DiscussionA higher prevalence of schizophrenia spectrum disorders has been described among patients suffering from Klinefelter syndrome, which might explain the role of the X chromosome in the susceptibility to psychiatric disorders, particularly to psychosis. Furthermore, the brain structure alterations presented by patients suffering from Klinefelter syndrome are similar to those described among schizophrenic patients: small brain volume, lateral cerebral ventricular enlargement and reduced temporal gyrus, amygdala, insula and cingulate cortex. Patients suffering from multiple sclerosis are more prone to psychiatric disorders, such as mood swing, aggressiveness or psychosis, which are not concurrent with the physical progression of the disease, sometimes being its first manifestation. Even when being patchy and multifocal, demyelination seems to be concentrated in the frontal lobes, related to the cognitive and affective functions and the personality.
ConclusionsBoth multiple sclerosis and Klinefelder syndrome may alter the brain structure, mainly in the frontal lobe, and predispose to psychiatric disorders.
Disclosure of interestThe authors have not supplied their declaration of competing interest.