Depression and physical disability outcomes in depressed medically ill hospitalized older adults.

The authors examined depression/disability outcomes in hospitalized older medical patients during the year after hospital discharge to assess the pattern and rate of changing depression and disability, the causal relationship between these variables, and to identify patients at greatest risk for poor outcomes. A group of 119 medical patients at Duke Hospital were both depressed and disabled; they were followed for a median of 47 weeks after hospital discharge. Time-series analyses showed that depression and disability tended to track together, and most changes occurred within the first 6 months after discharge.

Religiosity and remission of depression in medically ill older patients.

Objective: The effects of religious belief and activity on remission of depression were examined in medically ill hospitalized older patients.

Method: Consecutive patients aged 60 years or over who had been admitted to medical inpatient services at a university medical center were screened for depressive symptoms. Of 111 patients scoring 16 or higher on the Center for Epidemiologic Studies Depression Scale, 94 were diagnosed with depressive disorder (DSM-III major depression or subsyndromal depression) by a psychiatrist using a structured psychiatric interview.

Social correlates of the dimensions of depression in the elderly.

Few investigations of the social correlates of depressive symptomatology have addressed variation in the correlates across multiple dimensions of depression scales. We examined the relationships of selected social, clinical, and demographic correlates with four dimensions of the Center for Epidemiologic Studies-Depression (CES-D) scale in 3,401 community-dwelling elders in the Piedmont area of North Carolina. These correlates explained significant variation in somatic complaints and depressed affect; effects of chronic disability and recent negative events were particularly robust.

Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes.

Objective: The purpose of this study was to examine and compare rates of depression, correlates, and course of symptoms in medically ill hospitalized elders through use of six diagnostic schemes (inclusive, etiologic, exclusive-inclusive, exclusive-etiologic, substitutive-inclusive, and substitutive-etiologic).

Method: A consecutive series of 460 cognitively unimpaired patients aged 60 or over who were admitted to the medical inpatient services of Duke Hospital underwent a structured psychiatric evaluation administered by a psychiatrist. Patients with depression were contacted by telephone at 12-week intervals after discharge to assess weekly change in depressive symptoms (median follow-up time = 47 weeks).

Use of antidepressants by nonpsychiatrists in the treatment of medically ill hospitalized depressed elderly patients.

Objective: The purpose of this study was to examine antidepressant use by nonpsychiatrists in the treatment of depressed elderly medical inpatients.

Method: Patients aged 60 or older who were admitted to medical services at Duke Hospital were evaluated by a geropsychiatrist who used a structured psychiatric interview to identify major or minor depressive disorder. Medical records of depressed patients were reviewed for use of antidepressants and benzodiazepines before admission, during hospitalization, and on discharge.

Selective intraportal transplantation of DiI-marked isolated rat hepatocytes.

Transplantation of isolated hepatocytes is a promising alternative to orthotopic liver transplantation in experimental animal models with acute hepatic failure and hereditary enzyme defects. Conventional light microscopy identification of hepatocytes within recipient livers has been limited due to the inability to distinguish between donor and recipient liver cells. In this study, we labeled hepatocytes intracellularly with the fluorescent dye DiI-18 prior to selective intraportal or intrasplenic transplantation.

Modeling the cross-sectional relationships between religion, physical health, social support, and depressive symptoms.

The authors examined models of the relationships between religious activities, physical health, social support, and depressive symptoms in a sample of 4,000 persons age 65 and over. Religious activity was examined first as a single composite construct and then split into three component variables that were examined individually. Religious activity as a single construct was correlated with both social support and good physical health but was unrelated to depression.

Attendance at religious services, interleukin-6, and other biological parameters of immune function in older adults.

Objective: First, to examine and explain the relationship between religious service attendance and plasma Interleukin-6 (IL-6) levels, and second, to examine the relationship between religious attendance and other immune-system regulators and inflammatory substances.

Methods: During the third in-person interview (1992) of the Establishment of Populations for Epidemiologic Studies of the Elderly (EPESE) project, Duke site, 1718 subjects age sixty-five or over had blood drawn for analysis of immune regulators and inflammatory factors, including IL-6 measurements. IL-6 was examined both as a continuous variable and at a cutoff of 5 pg/ml.

Hospital stressors experienced by elderly medical inpatients: developing a Hospital Stress Index.

Objective: To develop a long and short version of an index to measure experiences during hospitalization perceived by elderly patients as stressful.

Samples And Methods: Consecutive patients aged sixty or over admitted to a university teaching hospital were assessed for hospital-related stressors during two separate studies. In the first study, seventy-six patients were asked an open-ended question exploring what they found most stressful about being in the hospital.

Mental health care for older adults in the year 2020: a dangerous and avoided topic.

Low Medicare reimbursement rates are already causing some mental health professionals to turn away elderly patients, restricting access to care. Where will funds come from to pay for the mental health needs of older adults in the year 2020, when 80 million baby boomers pass age 65? This cohort, in contrast to elders today, have high rates of psychiatric illness, and are also much more likely than older adults to seek mental health services. Seemingly oblivious to these trends, plans are being made to cut, rather than expand, the Medicare budget.

Religious affiliation and psychiatric disorder among Protestant baby boomers.

Objective: The authors examined the relationship between religious affiliation and psychiatric disorder among Protestant members of the baby-boom generation (those born between 1945 and 1966) who resided in the Piedmont area of North Carolina.

Methods: Data were obtained on six-month and lifetime rates of major psychiatric disorders among 853 Protestant baby boomers during wave II of the National Institute of Mental Health's Epidemiologic Catchment Area survey, conducted in 1983-1984. Participants were grouped into three categories based on religious affiliation: mainline Protestants, conservative Protestants, and Pentecostals.

Religious practices and alcoholism in a southern adult population.

Objective: The study examined associations between religious variables and alcohol abuse and dependence among 2,969 North Carolina residents aged 18 to 97 who participated in the 1983-1984 National Institute of Mental Health Epidemiologic Catchment Area survey at its Piedmont location.

Methods: Six-month and lifetime prevalence of alcohol disorders were compared among participants reporting varying levels of religious activity. Data were collected on frequency of Bible reading, prayer, and church attendance; time spent watching or listening to religious programming on television or radio; importance of religion; religious denomination; and identification as "born-again" Christians.

Abbreviating the Duke Social Support Index for use in chronically ill elderly individuals.

The 35-item Duke Social Support Index (DSSI) measures multiple dimensions of social support and has been used extensively in cross-sectional and longitudinal studies of aging. Epidemiological studies of chronically ill, frail elderly individuals often wish to include a measure of social support. However, most multidimensional measures (including the DSSI) are long and may exhaust the patient, especially when included in an often already congested interview schedule.

Bilateral discoid medial menisci: a case report and literature review.

The purpose of this article is to present the fourth case report of bilateral discoid medial menisci. A previously unreported anomaly of the tibial plateaus associated with the discoid menisci was also present bilaterally. The patient was treated successfully by excision of the central anomalous discoid portion of the menisci, using arthroscopic techniques.

Religious affiliation and major depression.

Data from the Duke Epidemiologic Catchment Area survey were used to examine the relationship between religious affiliation and major depression among 2,850 adults in the community. Religious affiliations were categorized into six groups: mainline Protestant (27 percent), conservative Protestant (59 percent), Pentecostal (4.2 percent), Catholic (2.