Rosenvinge H, Jones D, Judge E, Martin A
Harefield Day Hospital, Moorgreen Hospital, Southampton, UK.
Int J Geriatr Psychiatry. 1998 Jan;13(1):8-11.
The main hypothesis was that carers of elderly patients attending a day hospital with chronic depression experience considerable stress. A subsidiary hypothesis was that this stress is equivalent to that experienced by carers of dementia patients attending the same day hospital.
All attenders of the day hospital with a diagnosis of depression or dementia coresident with their principal carers.
An urban psychogeriatric day hospital in the UK.
A consultant diagnosis of dementia or depression with a history of present illness in excess of 12 months in patients over 65. The total sample was 57, 32 dementia and 25 depression (19 major depressive episode).
Dementia patients: Mini-Mental State Examination (MMSE), Clifton Assessment Schedule (CAPE). Depressed patients: MMSE, Montgomery-Asberg Depression Rating Scale (MADRS) and Brief Psychiatric Rating Scale (BPRS). Carers: Semi-structured questionnaire, General Health Questionnaire (GHQ-30) and Relatives Stress Scale (RSS).
Dementia patients were older than depressed (75.66 vs 71.84). The two groups were of comparable severity. The dementia carers were significantly more stressed on the GHQ and RSS than depression carers but these carers also exceeded the threshold for psychiatric 'caseness'. Important negative views about life upset and carer burden were expressed by both groups.
The main hypothesis but not the subsidiary one is supported. More sophisticated study of the burden of caring for chronic depressive illness is required.
主要假设是,在日间医院照料患有慢性抑郁症老年患者的照料者承受着相当大的压力。次要假设是,这种压力等同于在同一家日间医院照料痴呆症患者的照料者所经历的压力。
所有在日间医院就诊且诊断为抑郁症或痴呆症的患者与其主要照料者同住。
英国一家城市老年精神病日间医院。
经顾问诊断患有痴呆症或抑郁症,65岁以上患者目前患病史超过12个月。总样本为57例,其中32例为痴呆症患者,25例为抑郁症患者(19例为重度抑郁发作)。
痴呆症患者:简易精神状态检查表(MMSE)、克利夫顿评估量表(CAPE)。抑郁症患者:MMSE、蒙哥马利-艾斯伯格抑郁评定量表(MADRS)和简明精神病评定量表(BPRS)。照料者:半结构化问卷、一般健康问卷(GHQ-30)和亲属压力量表(RSS)。
痴呆症患者比抑郁症患者年龄更大(75.66岁对71.84岁)。两组病情严重程度相当。痴呆症患者的照料者在GHQ和RSS上的压力明显高于抑郁症患者的照料者,但这些照料者也超过了精神疾病“病例”阈值。两组都表达了对生活困扰和照料负担的重要负面看法。
主要假设得到支持,但次要假设未得到支持。需要对照料慢性抑郁症患者的负担进行更深入的研究。