High prevalence of anxiety symptoms in hospitalized geriatric patients

Kvaal, Kari; Macijauskienė, Jūratė; Engedal, Knut; Laake, Knut

doi:10.1002/gps.405

Cited by 57 publications

(50 citation statements)

References 19 publications

(27 reference statements)

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“…In a previous study among geriatric in-patients, we found that 41% of the female and 47% of the male patients had a mean sum score above 39 on the STAI state scale, which corresponded to significant anxiety symptoms (Kvaal et al, 2001a). In a follow-up study of the same patients it was found that the score on the STAI state scale increased one to three months after discharge, especially in relation to a lower score on the item 'I feel secure' (Kvaal and Laake, 2003).…”

Section: Introductionmentioning

confidence: 77%

The Spielberger State-Trait Anxiety Inventory (STAI): the state scale in detecting mental disorders in geriatric patients

Kvaal

Ulstein

Nordhus

et al. 2005

Int. J. Geriat. Psychiatry

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288

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SUMMARYBackground In geriatric psychiatry assessment scales are often used in clinical praxis in the diagnostic work-up of mental disorders. Aim To assess whether the state part of the STAI is useful as a case-finding instrument of mental disorders. Materials and method Data came from 70 non demented geriatric in-patients in stable clinical condition. Mean age was 83.3 years (range 64-96), and 74.3% were women. The 20-item STAI state instrument was used to measure current anxiety symptoms. Without knowledge of the score on STAI state a psychiatrist examined all patients and set diagnosis according to DSM-IV-TR criteria, but hierarchical rules were not used. Sensitivity, specificity, Likelihood ratio and accuracy were calculated for different cut-points of the mean sumscore on the STAI state. Results 15.7% of the participants suffered from a mental disorder: GAD ¼ 1, mixed anxiety-depression ¼ 5, depression ¼ 1, dystymic ¼ 1, adjustment disorder (mixed anxiey-depression) ¼ 1, and personality disorder ¼ 1. The mean STAI sumscore in this group was 56.3 compared with 39.2 in the 59 patients without any psychiatric diagnosis. The optimal cut-off score on the STAI mean sumscore corresponding to the highest accuracy of 0.87 was 55/54 with sensitivity 0.82, specificity 0.88, and LR þ 6.8. Conclusion The STAI state scale is a useful instrument for detecting a variety of mental disorders in older people. Further studies should be carried out in different populations.

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Section: Introductionmentioning

confidence: 77%

The Spielberger State-Trait Anxiety Inventory (STAI): the state scale in detecting mental disorders in geriatric patients

Kvaal

Ulstein

Nordhus

et al. 2005

Int. J. Geriat. Psychiatry

Self Cite

288

208

View full text Add to dashboard Cite

show abstract

“…It is well known (cf. Ellefsen 2002;Kvaal et al 2001;Rannhoff 1997) that a frail elderly person, who has a dependency on others, may experience feelings of insecurity, anxiety and distress for the future. On the other hand, Pot et al (2005) found that transitions in professional care may increase older adults' depression symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…It is already known that the consequences of comorbidity, pain and low functional ability are often helplessness and dependency, which can contribute to a higher frequency of anxiety, feelings of insecurity and mental disorders (Grimmer et al 2004;Kvaal and Laake 2003;Ellefsen 2002;Hellsröm and Hallberg 2001;Kvaal et al 2001;Rannhoff 1997). Janlöv et al (2005) underline that when older people face the fact that they need help, it evokes anxiety as it means a new, unknown and potentially unpleasant situation (see also Pot et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Home-care clients’ need for help, and use and costs of services

2008

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The aims of the study were to describe (1) the need for help as well as the use and costs of services of home help and/or home nursing (home care) and (2) to identify the variables associated with the use and costs of health and social care services. A total of 721 Finnish home-care clients were interviewed in 2001. The need for help was assessed by basic and instrumental activities of daily Living (ADL) and in terms of pain and illness, rest and sleep, psychosocial well-being and social and environment variables. The Anderson-Newman model was used to study predictors of use of services, including visits of home-care personnel and visits to the doctor, nurse, physiotherapist, laboratory and hospital. Weekly costs of services were calculated. Data were analyzed using multivariate analyses. The clients had poor functional ability and they needed help at least once a week with, on average, 6 out of 15 ADL functions, and 5 out of 13 items relating to pain and illnesses, rest and sleep, psychosocial well-being and social and environment items. The enabling and need variables, particularly the variables ''living alone'' and ''perceived need for help'', were important predictors for the use of services. Social care constituted more than half of the average weekly costs of municipalities. The perceived need for help with basic ADL was associated with higher costs. To ensure the quality of life among home-care clients while keeping costs reasonable is a challenge for municipalities.

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“…Questionnaires designed to screen for anxiety that include a large number of somatic complaints, such as breathlessness and fatigue, are likely to overestimate the prevalence of anxiety in COPD, since such symptoms may also be associated with the primary respiratory impairment. Notwithstanding these considerations, greater levels of anxiety have been reported in patients with COPD compared with those with heart disease and cancer [23]. …”

mentioning

confidence: 99%

Anxiety and depression in end-stage COPD

Hill

Geist²,

Goldstein³

et al. 2008

European Respiratory Journal

227

142

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Although feelings of anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), estimates of their prevalence vary considerably. This probably reflects the variety of scales and methods used to measure such symptoms. Regardless of whether anxiety and depression are considered separately or as a single construct, their impact on COPD patients is important.A heightened experience of dyspnoea is likely to be a contributing factor to anxiety. Feelings of depression may be precipitated by the loss and grief associated with the disability of COPD. Smoking has been associated with nicotine addiction, and the factors that contribute to smoking may also predispose to anxiety and depressive disorders.Randomised controlled trials indicate that exercise training and carefully selected pharmacological therapy are often effective in ameliorating anxiety and depression. Most medical illnesses are influenced by the psychological responses and coping mechanisms that patients use. However, anxiety and depression are associated with dyspnoea, fatigue and altered sleep, all of which also occur in COPD.An understanding of the psychological history and coping mechanisms of patients and the role of anxiety and depressive reactions to illness may enable clinicians to reduce these symptoms and improve quality of life among patients with chronic obstructive pulmonary disease.KEYWORDS: Anxiety, chronic obstructive pulmonary disease, depression C hronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction that is not fully reversible [1]. In addition to the primary pulmonary pathology, the impact of secondary skeletal muscle dysfunction on exercise capacity and survival is well established [2,3]. Psychological impairments, ranging from feelings of depression and anxiety to full diagnostic mental disorders, although prevalent in this population, have received less interest. As COPD is incurable, therapeutic interventions aim to optimise function and slow disease progression [4]. Attention has focused predominantly on the effectiveness of strategies such as smoking cessation [5], longterm oxygen therapy (LTOT) [6,7], influenza vaccines [8], respiratory-specific pharmacological management [9], surgical options [10], conditioning of the peripheral muscles with graduated exercise training [11] and chronic disease selfmanagement strategies [12].Despite the prevalence of depression and anxiety and their impact on the morbidity associated with COPD, these psychological consequences of the disease are rarely addressed, at least in the respiratory medicine community. The purpose of the present review is to raise awareness among pulmonologists, general practitioners and allied health professionals to the secondary psychological impairment associated with COPD. Although anxiety and depression often coexist, they represent separate constructs [13]. Broader reviews of the psychological characteristics of patients with COPD are available [14]. ANXIETY Classification and diagnostic cr...

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High prevalence of anxiety symptoms in hospitalized geriatric patients

Abstract: STAI proved feasible for use in the elderly. The scoring on the STAI is high in geriatric in-patients. Further studies are needed to clarify to what extent this relates to a high prevalence of anxiety disorders.

Cited by 57 publications

References 19 publications

The Spielberger State-Trait Anxiety Inventory (STAI): the state scale in detecting mental disorders in geriatric patients

The Spielberger State-Trait Anxiety Inventory (STAI): the state scale in detecting mental disorders in geriatric patients

Home-care clients’ need for help, and use and costs of services

Anxiety and depression in end-stage COPD

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