Three samples of supporters of elderly infirm dependents who were either attending or about to attend day hospitals were given the 30-item General Health Questionnaire (GHQ) to complete. Prevalence levels of disturbance varied from 57% to 73%; female supporters (the majority) reported higher levels of distress. High scores were related to a diagnosable psychiatric condition, and were significantly associated with a combination of poor self-health ratings in the supporters, more frequent behaviour problems in the dependents and a more negative view of the premorbid relationship between supporter and dependent. Reported amount of contact time and levels of formal and informal outside support were not related to GHQ scores.

In this review, we begin by considering why post-stroke depression (PSD) is so prevalent. We then examine the current evidence base to support cognitive behavioural therapy (CBT) as a treatment approach for the condition. While there is limited evidence currently, we demonstrate that much remains to be established with regard to PSD and the efficacy of CBT. We argue there is every reason to believe CBT should be an effective treatment, but that clinicians must augment and individually tailor this approach to ensure effectiveness. We set out our rationale for a novel augmented, individually tailored CBT protocol, and describe five key components that we believe once incorporated, and tested using randomized controlled methods, should enhance treatment outcome of PSD.

Supervisory care for demented elderly people should be further developed within an expanded domiciliary service to meet supporters needs.

This paper presents findings on the association between 'expressed emotion' (EE) and a number of factors previously investigated in relationship to caregivers of the dementing elderly. Frequency of critical comments (expressed emotion) was correlated with a number of supporter and dependent characteristics, variables within the relationship between caregivers and their dementing relatives, and help from professionals. The analysis revealed significant correlations between EE and sex of caregiver, caregivers' psychological well-being, contact with friends and the quality of the relationship between the caregiver and dementing relative. The dementing relatives' level of impairment, age and sex were not significantly correlated with EE, nor was help from the services. Also, those most critical of their dementing relatives were not more likely to express a preference for institutional care.

No abstract