Psychiatric morbidity in the dependent aged was studied in the elderly population of Hobart's nursing homes and long-stay hospitals. Only patients with home addresses in Hobart and who were admitted for the first time aged 70 years or over were included. Three hundred and twelve persons were interviewed with a standard interview, and an informant was interviewed when appropriate. The medical records were searched for diagnoses and drug treatments. Physical disability was rated on an ad hoc scale. Comparisons were made of the prevalence of dementia, depression and anxiety in different types of unit, and between these and two domiciliary samples, one of which received domiciliary nursing services (n = 100) and the other not (n = 100). The differential use of institutions by men and women, and a possible sex difference in the prevalence of dementia is discussed.

SUMMARYThe level of dependency of 412 patients aged 70 years or over living in hospitals, nursing homes or sheltered accommodation (N=312) or receiving care from the domiciliary nursing services (N= 100) and of 100 elderly people living in the community in Hobart, Tasmania, was assessed using a version of the CARE schedule. The respective roles of mental and physical factors were examined using other CARE items and after administering the Geriatric Mental Status schedule and the Wechsler Memory Scale. Rank-order correlations and log-linear analyses indicated that physical impairment affecting mobility and upper limb function and cognitive impairment due to dementia were about equally strongly related to the level of dependency; at least moderate degrees of both mental and physical impairment were present in 20% of patients. Vision was often hard to assess in demented patients but was associated with dependency in the non-demented. Dependency was significantly related to age and self-rated health but not to deafness and was related to mood disorder only in non-demented patients nursed at home. Apart from this, these patients showed similar relations between dependency and physical and mental impairments to those living in institutions. Central nervous system disease was associated with greater dependency than other medical diagnoses. Preventative programmes, and effective management and treatment of the individual, will depend on careful diagnosis of the causes of dependency.

Purpose: This study uses participatory research methods with survivors of homicide and their service providers to explore the feasibility and acceptability of a culturally-adapted mindfulness intervention for stresss reduction and resilience in homicide survivors. Procedures: Our mixed methods approach included: (a) previewing a Mindfulness Based Stress Reduction program with providers and Survivors; (b) using their iterative feedback during focus groups to revise the curriculum; and (c) studying the acceptability of the adapted curriculum for Survivors? through focus group and standardized data collection. Findings: We learned that providers use mindfulness for self-care and both providers and survivors view the approach for Survivors as promising. Based on attendance, participation and focus group data, the adapted curriculum was both feasible and acceptable. Survivors’ reports suggested most experienced improved emotion regulation, feelings of empowerment and better coping. Conclusions: Culturally-adapted mindfulness programs may support healing for homicide survivors and possibly other low income people of color with significant trauma backgrounds. Further investigation is needed to rigorously assess outcomes and specific effects, both positive and negative, of mindfulness in this population.

Objective: PTSD-depression has high comorbidity and understanding their relationship is of clinical and theoretical importance. A comprehensive way to understand posttrauma psychopathology is through symptom trajectories. The study aimed to look at the developmental courses of PTSD and depression symptoms in the initial months posttrauma, and their interrelationship in children and adolescents by utilizing advanced group-based trajectory modeling (GBTM). Methods: Two-hundred-and-seventeen children and adolescents aged between eight and 17 exposed to single-event trauma were included in the study. Their PTSD and depression symptoms were measured at two weeks, two months and nine months, with further psychological variables measures at the two-week assessment. Results: The GBTM modeling yielded a three-group model for PTSD and a three-group model for depression. All participants’ PTSD symptoms reduced to non-clinical level by nine months: participants were observed to be resilient (42.4%) or to be able to recover within two months (35.6%), while 21.9% experienced high level PTSD symptoms but recovered in nine months time. The depression trajectories described a chronic non-recovery depression group (20.1%) and two mild symptom groups (45.9%, 34.0%). Further analysis showed high synchronicity between PTSS and depression groups but predictor analysis revealed disparate predictors. Perievent panic (CPP), appraisal (CPTCI), rumination and thought suppression at week two predicted slow recovery from PTSS, while pre-trauma wellbeing (CPAS), post-trauma anxiety (SCAS) and appraisal (CPTCI) predicted chronic depression. Conclusions: Posttrauma depression was more persisting than PTSD symptoms at nine months in the sampled population. Cognitive appraisal may be central to explaining PTSD-depression comorbidity.