Rafael A Rivas-Vazquez, Samantha G Diaz, Carla Rodriguez, Emma V Rivas-Vazquez, Gustavo J Rey
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引用次数: 0
摘要
目的:老年抑郁症是一种常见的致残性精神健康状况,往往未被发现,可能是由于不太典型的抱怨和更多的躯体性质。易怒既不是成人抑郁症的正式标准,也不是常规筛查工具的组成部分;然而,它通常在老年人中表达。本研究的目的是确定60岁及以上成年人易怒的频率,并确定其在检测老年抑郁症中的效用。方法:回顾性数据来自于2015年1月至2023年2月在我们诊所就诊的2300名患者的图表回顾。采用贝克抑郁量表- ii (BDI-II)确定抑郁。易怒程度是通过一个包含2个项目的筛选工具来确定的,评估主观的易怒体验和他人对易怒程度的观察。结果:在1317名符合纳入标准的研究参与者中,514人(40%)对烦躁反应积极。与否认易怒的个体相比,该组的BDI-II得分明显较高(P< 0.001)。在初级保健机构中使用推荐的BDI-II切点,符合抑郁症标准的参与者(n = 488, 37%)报告的易怒程度明显高于无抑郁症的参与者(P < 0.001)。结论:在我们的样本中,易怒与较高程度的抑郁有关。除了使用传统的抑郁症筛查工具外,从业人员与老年人一起工作时应该询问是否存在烦躁情绪,无论是主观体验还是他人观察到的。易怒似乎是一个有用的标志,以方便检测和后续治疗老年抑郁症。中枢神经系统疾病诊治[j]; 2015;27(1):24m03808。本文末尾列出了作者所属单位。
Importance of Screening for Irritability When Assessing for Geriatric Depression.
Objective: Geriatric depression is a common and disabling mental health condition that often goes undetected, possibly due to complaints that are less typical and more somatic in nature. Irritability is neither a formal criterion for depression in adults nor a component of routine screening instruments; however, it is commonly expressed by older adults. The objective of this study was to establish the frequency of irritability in adults aged 60 and older and determine its utility in detecting geriatric depression.
Methods: Retrospective data were derived from a chart review of 2,300 individuals referred to our clinic from January 2015 to February 2023. Depression was established using the Beck Depression Inventory-II (BDI-II). Irritability was determined using a screening instrument containing 2 items assessing subjective experience of irritability and observations of irritability by others.
Results: Of 1,317 study participants meeting inclusion criteria, 514 (40%) responded positive for irritability. This group had significantly higher BDI-II scores compared to individuals denying irritability (P< .001). Using the recommended cut point for the BDI-II in primary care settings, participants meeting criteria for depression (n = 488, 37%) reported significantly greater levels of irritability than those without depression (P < .001).
Conclusions: In our sample, irritability was associated with higher levels of depression. In addition to employing traditional screening instruments for depression, practitioners working with a geriatric population should inquire as to the presence of irritability, either subjectively experienced or observed by others. Irritability appears to be a useful marker to facilitate detection and subsequent treatment of geriatric depression.
Prim Care Companion CNS Disord 2025;27(1):24m03808.
Author affiliations are listed at the end of this article.
期刊介绍:
Founded in 1998, The Primary Care Companion for CNS Disorders (ISSN 2155-7780), formerly The Primary Care Companion to The Journal of Clinical Psychiatry, is an international, peer-reviewed, online-only journal, and its articles are indexed by the National Library of Medicine. PCC seeks to advance the clinical expertise of primary care physicians and other health care professionals who treat patients with mental and neurologic illnesses. PCC publishes research from disciplines such as medicine, nursing, pharmacy, and psychology, especially as it pertains to integrated delivery systems and interdisciplinary collaboration. PCC focuses on providing information of direct clinical utility and giving a voice to clinician researchers. Practice-based research from individuals and groups with clinical expertise is particularly welcome. Pertinent manuscript types include: -Original research -Systematic reviews -Meta-analyses -Case reports and series -Commenting letters to the editor Articles published in PCC typically cover attention-deficit/hyperactivity disorder, depression, bipolar disorder, anxiety, addiction, sleep disorders, pain, Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease.