Mental disorder among nursing home patients: Preliminary findings from the national nursing home survey pretest

Burns, Barbara J.; Larson, David B.; Goldstrom, Ingrid D.; Johnson, Wayne E.; Taube, Carl A.; Miller, Nancy E.; E, Mathis

doi:10.1002/gps.930030105

Cited by 82 publications

(26 citation statements)

References 12 publications

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“…Both shortly after admission and 6 months later, neuroleptics are the most frequently taken drug classes, which is in accordance with the data of authors using a point-prevalence design (e.g. Mann et al 1984Mann et al , 1986Burns et al 1988;Beardsly et al 1989). To our knowledge, no authors investigating psychotropic drug intake shortly after admission have compared different types of psychotropics.…”

Section: Discussionsupporting

confidence: 71%

“…Kalchthaler et al 1977;Segal et al 1979;Ray et al 1980;Clarke et al 1981;Beers et al 1988;Buck 1988;Burns et al 1988;Beardsly et al 1989). The rates of psychotropic drug intake reported from these studies lie between 32 % (Burns et al 1988) and 86% (Segal et al 1979). Of the different types of psychotropic drugs, most studies indicated that neuroleptics or hypnotics were used most frequently, while the use of antidepressants and anxiolytics was less common.…”

Section: Introductionmentioning

confidence: 94%

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Psychotropic drug intake in residents newly admitted to nursing homes

et al. 1997

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While several surveys have shown that psychotropic drugs are frequently used by nursing home residents, no studies have been performed to investigate whether the rates of drug use increase during the stay in nursing homes or whether residents have taken these drugs already before admission. Therefore, we investigated 262 residents admitted to rural and urban nursing homes in Austria for prevalence of psychotropic drug intake before admission, shortly after admission, and 6 months later. Two weeks after admission, 72.1% of the residents were being treated with psychotropics, while 6 months later 79.0% were receiving these drugs. The significantly higher rates of psychotropic drug use among the psychiatrically ill and in those suffering from sleeping problems suggest that these drugs were prescribed aptly, but residents without appropriate criteria for drug intake were often also treated with psychotropics. During 3 months before admission to nursing homes, 45.5% of the sample reported having taken psychotropics. In more than half of residents without drug intake before admission, psychotropic treatment was initiated within the first 2 weeks after admission, while during the first 6 months after admission the rate of drug use increased only slightly. This suggests that a large percentage of psychotropic intake is due to nursing home orders.

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 94%

Psychotropic drug intake in residents newly admitted to nursing homes

et al. 1997

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“…An association between decline in brain dopaminergic activity with age and cognitive and motor impairment has been shown in healthy volunteers (Volkow et al, 1998) The elderly The elderly are becoming an increasingly important group at risk of depression. It has been estimated that up to 18% of elderly people in the community have symptomatic depression (Evans et al, 1991;Raskind, 1992), whilst the incidence among geriatric patients in nursing homes and those with chronic diseases may be substantially higher (Burns et al, 1988). However, depression in the elderly frequently goes undiagnosed because many patients and their families mistake it to be part of the normal aging process.…”

Section: Cognitive Dysfunctionmentioning

confidence: 97%

Selective serotonin reuptake inhibitors in affective disorders -II. Efficacy and quality of life

Goodnick¹,

Goldstein

1998

J Psychopharmacol

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Since their introduction, the selective serotonin reuptake inhibitors (SSRIs) have become one of the most widely used classes of medication in psychiatry. Their popularity is based on apparent efficacy over a wide range of disorders and a favorable side-effect profile. However, as with any psychotropic medication, considerable data are required to define where a drug works and where it does not. There is now a wealth of evidence demonstrating that SSRIs may differ in their efficacy profiles in certain depressive symptoms, in different subtypes of depression, with respect to their ability to maintain efficacy over time, on broader outcomes such as quality of life, and in the consistency of the usually effective minimum therapeutic dose across the age spectrum and across indications. Although this review includes data on all SSRIs, it focuses on fluoxetine and sertraline, which in addition to being the most widely used SSRIs are also the most widely studied. The relative quantity and quality of data on these two SSRIs means that it is possible to make relatively firm inferences regarding their differential effects on affective symptoms and quality of life.

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“…More recently, the 1985 National Nursing Home Survey (National Center for Health Statistics, 1989) and the earlier NNHS pretest (Burns et al, 1988) found that 63% of residents had a dementing illness. These surveys, however, relied on reviews of nursing records and interviews with nursing staff conducted by non-clinicians.…”

Section: Epidemiologymentioning

confidence: 98%

Psychiatric disorders in the nursing home: A selective review of studies related to clinical care

Rovner¹,

Katz²

1993

Int J Geriat Psychiatry

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SUMMARYExisting research demonstrates that nursing homes are the modern mental institutions for the elderly in the United States, but that training of staff and physicians, processes of care, and the recognition and treatment of mental disorders lag behind the current state of scientific knowledge. The prevalence of diagnosable psychiatric disorders has been estimated to be 80% or higher. The most common of these disorders are the dementias, primarily Alzheimer's or vascular, that can be uncomplicated or complicated by the presence of hallucinations, delusions, depression or behavioral symptoms. Other common disorders include depression and delirium. Problems currently under investigation include the effectiveness of special care units for patients with dementia, the characterization and treatment of the non-cognitive, psychiatric symptoms of dementia, including consideration of the appropriate use of psychotropic medications, and the recognition, diagnosis, and treatment of depression. Although there is a clear need for more research, the available data already demonstrate the need for augmented psychiatric input into nursing home care.

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Mental disorder among nursing home patients: Preliminary findings from the national nursing home survey pretest

Cited by 82 publications

References 12 publications

Psychotropic drug intake in residents newly admitted to nursing homes

Psychotropic drug intake in residents newly admitted to nursing homes

Selective serotonin reuptake inhibitors in affective disorders -II. Efficacy and quality of life

Psychiatric disorders in the nursing home: A selective review of studies related to clinical care

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