Mental illness in a cross-national perspective

Abstract

Findings for unselected samples for the elderly in two urban populations - one in Mannheim, Germany (n = 418) and the other in Sao Paulo, Brazil (n = 111) - are compared and contrasted. Each study was restricted to persons aged over 65 years living in private households, and each employed a single-stage method of psychiatric case-identification, based on the Clinical Interview Schedule (CIS). Apart from marked differences in educational standards and proportions living alone the two samples were broadly similar in their recorded socio-demographic characteristics. Comparison revealed no significant difference in total prevalence, though there was a trend towards a higher case-frequency in Sao Paulo (29.7%) than in Mannheim (23.3%). The clinical-item profiles for the two samples indicated a higher rate of symptom reporting in Sao Paulo, whereas the Mannheim sample had higher mean scores for a number of psychiatric abnormalities observed at interview. Separate cluster analyses carried out on the two data sets divided the samples into four pairs of sub-groups with similar clinical profiles, which were designated respectively as 'organic', 'depressive', 'neurotic' and 'normal'. While a more careful standardization of method would probably reduce the observed disparities between the samples, some of these are thought to be real and to relate to sociocultural differences, as well as to the greater stresses of daily life in Sao Paulo.

Associations between the variables institutionalization, education, polypharmacy, depression and cognitive impairment in two heterogeneous groups of the elderly

“…The results regarding the prevalence of depression indicate, for the sample studied, a situation in addition to that presented in the literature, which indicates that depression generally has prevalence rates between 5% and 35%, varying according to severity level and, that among the population over 65 years (Heiser, 2004), in Brazil it has a prevalence of around 15% (Blay, et al, 1991). The results of this research diverge from the estimates of Reys and collaborators (2006) and Siqueira and collaborators (2009), according to which the incidence of depression in elderly people living in the community is approximately 14% and that among those residing in LTC's this index varies between 15% and 50%.…”