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Biomedical subjects

D Blazer

Publications and source records attributed to D Blazer.

71 records · Page 4Linked to original sources
PubMed1981

Chronic pain: a multiaxial approach to psychosocial assessment and intervention.

With the advent of new and improved psychiatric treatment of chronic pain, increased interest has been directed toward psychosocial factors that contribute to chronic pain. Attention has been focused on assessing chronic pain and selecting therapy according to desired changes in symptoms or behavior. This report presents a conceptual framework for assessing chronic pain, as well as technics of psychosocial management of it.

Chronic Disease↗
PubMed1980

The diagnosis of depression in the elderly.

The reported prevalence of depressive symptomatology among the elderly ranges from 5 to 65 percent in hospital and community populations. Depression is considered the most common emotional disorder of advanced age. One of the chief diagnostic problems has been the lack of differentiation between disorders manifested by dysphoric or depressive symptoms. Recent work on operational criteris, as exemplified in the Third Edition of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-III) provides a basis from which the diagnosis of depression can be made and subgroups of elderly depressed subjects can be delineated. A community survey involving a stratified random sample of 997 persons aged 65 or older living in Durham County was completed in 1972. An 18-item subscale eliciting depressive symptomatology was abstracted from the survey questionnaire and submitted to factor analysis, tests of reliability, and association with clinical diagnosis. The instrument proved to be a useful means of identifying persons with depressive symptomatology, as outlined in DSM-III. It also can be used for epidemiologic studies of depression in the elderly.

Adult↗
PubMed1980

Epidemiology of dysphoria and depression in an elderly population.

The authors surveyed 997 elderly people living in the community and found that the rate of significant dysphoric symptomatology was 14.7%. Forty-five (4.5%) of these individuals suffered from dysphoric symptoms only, and 37 (3.7%) had symptoms of a major depressive disorder. Eighteen (1.8%) suffered from symptoms of primary depressive disorder and 19 (1.9%) from symptoms of secondary depressive disorder. Sixty-five (6.5%) had depressive symptoms associated with impaired physical health. The frequency of widowhood, impairment in social resources, and impairment in economic resources was greater for individuals with symptoms of a major depressive disorder. The entire sample used psychiatric services at a very low rate.

Activities of Daily Living↗
PubMed1980

Older adults and their families in a community mental health center: strategies for intervention.

Clinicians at a geriatric evaluation and treatment clinic include the patient's family in all stages of assessment and intervention so that the family can ultimately assume much of the responsibility for care. The family's strengths and weaknesses and its potential as a caretaker are assessed through a questionnaire and interviews. The major intervention techniques include explaining the patient's impairment and capabilities to the family, coordinating needed community resources, encouraging respite activities, allowing relatives to work through their own feelings, and taking responsibility for decision-making when necessary. A case history illustrates the assessment and intervention techniques.

Aged↗
PubMed1980

Life events, mental health functioning and the use of health care services by the elderly.

The association of life events and mental health impairment was studied in a community-based population of the elderly (n = 986). A crude estimate of the relative risk for mental health impairment given life events larger than or equal to 150 (as measured by the Schedule of Recent Events) was 2.14. A relative risk of 1.73 (p < .01) was estimated when a binary regression procedure was used, controlling for physical health, economic status, social support, and age. Increased life events were associated with health seeking behavior, even when physical and mental health functioning were controlled. The associations between increased life events and both mental health functioning and health seeking behavior were small, suggesting that life events, as measured by the Schedule of Recent Events may not be important risk factors for elderly living in the community.

Activities of Daily Living↗
PubMed1978

Techniques for communicating with your elderly patient.

A physician can best treat elderly patients if he or she understands their unique problems and employs effective techniques of communication. Be aware how your patient's anxiety or your own view about the elderly can erect a barrier to communication. Your position in the room, your tone of voice, your touch all communicate--either positively or negatively--to your elderly patient.

Aged↗
PubMed1977

Anorexia nervosa: a combined therapeutic approach.

Ten female patients with a diagnosis of anorexia nervosa were treated with a combination of behavior modification and psychotherapy and, when appropriate, psychotropic medication. All patients had favorable weight gain and improvement in adjustment during hospitalization. Later crises for each patient thus far have not significantly affected their weight. Three case histories illustrate the method used. The interrelationship between weight gain and the process in psychotherapy is illustrated and the psychopathologic features typical of this patient population are discussed. We conclude that the combined therapeutic method described is an effective and appropriate approach to the treatment of patients with anorexia nervosa.

Adult↗
PubMedDate not supplied

A statistical analysis of the classification of depression in a mixed community and clinical sample.

Depressive symptoms in three samples are assessed using grade-of-membership analysis to clarify the distribution of depressive symptoms across traditional affective diagnoses. The technique is used to examine whether depressive symptoms and symptoms frequently associated with depressive disorders cluster into recognizable syndromes or pure types that parallel current operational diagnoses. Three hundred and ninety subjects were studied to address the question: among a mixed population with a range of depressive symptoms, will syndromes resembling endogenous depression and demoralization emerge from the range of presentation of depressive symptoms? A single pure type is nearly identical to the DSM-III classification of major depression with melancholia. No such pure type emerged that resembled demoralization.

Adult↗
PubMedDate not supplied

Demographic and health characteristics of elderly smokers: results from established populations for epidemiologic studies of the elderly.

Although smoking has been shown to be associated with excess morbidity and mortality, most studies have focused on young and middle-aged rather than elderly smokers. We examined the demographic characteristics and physical and psychological health of elderly cigarette smokers in four population-based studies (N = 3,673, 3,811, 2,811, and 4,165) of persons 65 years of age and older. Although there was substantial geographic variation in the percentages of smokers, the demographic and health characteristics of smokers were similar across the sites. Most women had never smoked, but most men were former or current smokers. The percentage of never smokers was highest in the "oldest old." Among the elderly ever smokers, men were more likely to have quit than women, and the relative percentage of former smokers increased with age. Current smokers were generally more likely to consume alcohol than never smokers. In this age group, cigarette smoking was typically associated with higher rates of physical disease and symptoms, poorer self-perceived health status, and higher levels of depressive symptoms. Based on these four large geographically diverse population surveys, cigarette smoking remains an important health burden and public health challenge among the elderly.

Aged↗
PubMedDate not supplied

The health burden of diabetes for the elderly in four communities.

Although diabetes is a common health problem of the elderly, the impact of diabetes on health and functioning in older persons is not well established. The purpose of this analysis was to identify health conditions accompanying diabetes in four samples of community dwelling elderly people. The study samples consisted of 13,601 persons ages 65 or older who participated in the Established Populations for Epidemiologic Studies in the Elderly (EPESE). Extensive interviews were conducted in respondents' homes to obtain information on diabetes and other health conditions, health behaviors, use of health services, and demographic characteristics. A lifetime history of diabetes was reported by 14 percent of respondents. The prevalence of the disease was higher in blacks than whites, especially among women. Persons with diabetes were more likely to report myocardial infarction, stroke, vision problems, physical disability, incontinence, and nursing home stays than persons without diabetes, but the diabetics were less likely to consume alcohol or tobacco. Those with diabetes were only slightly heavier than those without diabetes at the time of the interview. However, body mass at age 50 was substantially greater among persons with diabetes. Associations between diabetes and other health conditions and behaviors were similar for whites and blacks. These results show that aged persons with diabetes experience substantial comorbidity, which has important ramifications for functioning and survival.

Activities of Daily Living↗