Coding of treatment-goal themes with the BIT-T provides researchers as well as practitioners with valuable information that goes beyond psychopathological diagnoses. This information can be used clinically for treatment planning as well as outcome evaluation.
The present study, conducted in collaboration between the Departments of Psychiatry in Swiss Universities and the World Health Organization, had two main goals: to develop assessment methods which could subsequently be used in the Swiss centres in a standard manner; and to make arrangements for continuing collaboration between the centres in Switzerland and the acquisition of new knowledge about the distinctions between depression and cognitive impairment. For this aim, three different groups of elderly patients of either sex were selected during the period of November 1989 to July 1991 for inclusion in the study. The first two groups included the first ten patients of either sex over 60 years of age consecutively contacting the participating institutions and showing depression with or without clinically significant symptoms of cognitive impairment; the control group included patients showing no depression or clinically significant symptoms of cognitive impairment. A total of 125 patients were included in the initial evaluation, 69 of which were reassessed at a seven-month follow up (on average). Each patient was administered a number of clinician-rated or self-report instruments for the assessment of depression, cognitive impairment, disabilities, physical status and onset of disorders. The study has shown that a variety of instruments can be used for the reliable assessment of depression or cognitive impairment in the elderly; but the instruments for the assessment of depression differentiate only poorly between patients with or without cognitive impairment. Because of the importance of identifying both depressed and cognitively impaired patients among the elderly, different assessment instruments targeted at the different symptom clusters need to be administered simultaneously.
ResumenEl presente estudio, realizado en colaboración entre los Departamentos de Psiquiatría en universidades suizas y la Organización Mundial de la Salud, tiene dos metas principales: desarrollar métodos de evaluación que se puedan utilizar posteriormente en los centros suizos de una manera estándar, y tomar medidas para la colaboración continuada entre los centros en Suiza y la adquisición de nuevos conocimientos sobre las distinciones entre depresión y deterioro cognitivo. Con este propósito se seleccionaron tres grupos diferentes de pacientes ancianos de ambos sexos durante el periodo de noviembre de 1989 a julio de 1991 para su incorporación al estudio. Los dos primeros grupos incluían a los primeros diez pacientes de ambos sexos con más de 60 años de edad que contactaron consecutivamente con las instituciones participantes y que mostraban depresión con o sin síntomas clínicos significativos de deterioro cognitivo; el grupo de control incluía pacientes que no mostraban depresión o síntomas clínicos significativos de deterioro cognitivo. En la valoración inicial se incluyó un total de 125 pacientes, 69 de los cuales fueron evaluados de nuevo en un seguimiento a los siete meses (como media). Se administraron a cada paciente varios instrumentos calificados por el clínico o de autoinforme para la evaluación de la depresión, el deterioro cognitivo, las discapacidades, el estado físico y el comienzo de los trastornos.El estudio ha mostrado que se pueden utilizar diversos instrumentos para la evaluación fiable de la depresión o el deterioro cognitivo en los ancianos, pero los instrumentos para la evaluación de la depresión diferencian sólo pobremente entre pacientes con deterioro cognitivo o sin él. Debido a la importancia de identificar entre los ancianos tanto a pacientes deprimidos como a pacientes con deterioro cognitivo, es necesario administrar simultáneamente instrumentos de evaluación diferentes dirigidos a grupos de síntomas diferentes
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