Treatment Status of Elderly Patients With Severe Mental Disorders in Rural China

Abstract

This study was performed to compare the treatment status between older (≥65 years) and younger adults (18-64 years) with severe mental illness (SMI) and explore factors associated with treatment status in rural China. Persons with SMI were identified in one mental health survey in 2015 in 6 townships of Xinjin County, Chengdu, China. Logistic regressions were conducted to explore factors associated with treatment status. Older adults with SMI, especially major depressive disorder, reported significantly lower rates of treatment than younger group. Older age, longer duration of illness, and poor mental status were risk factors for never-treated status in these patients. Never-treated status (46.3%) and poor treatment status in these older patients are serious issues. Different treatment statuses in these patients had various influencing factors. It is crucial to develop culture-specific, community-based mental health services to improve early identification, diagnosis, treatment, and recovery of older adults with SMI in rural China.

Impacts of depression subcase and case on all‐cause mortality in older people: The findings from the multi‐centre community‐based cohort study in China

“…As the world population continues to age, there are more people living with depression, and many of them are underdetected 14 and untreated. 19 Our study has provided evidence of the impact of older age depression subcases on increased risk of all-cause mortality. Moreover, older people with subcases of depression face a comparable risk of all-cause mortality to those with full cases of depression.…”

“…The stronger impact of depression on all-cause mortality in the older Chinese population could be due to high levels of socioeconomic deprivation, depression under-detection for treatment and low levels of health care and medications. 7,14,19 The findings of our study from China-the largest LMIC, which accounted for important co-variables including low educational level, rural areas and financial difficulties, could suggest an independent impact of depression on excess mortality regardless of country or region, although the magnitude of the impact varied in older people with depression subcase and case among different populations. Studies in the HICs and West 3,20,21 showed that older men with depression case versus non depression had a higher RR of all-cause mortality than their female counterparts.…”

“…To the best of our knowledge, this is the first study to report gender differences in the association of depression subcases with all-cause mortality in LMICs, addressing that women had higher inequality in survival in relation to depression subcases. Since older people with depression in China rarely go to hospital for diagnosis 14 and treatment, 19 the studied population would be in a "natural" status for observing depression prognosis. The survival in older people with depression largely depended on other factors, such as socioeconomic status and social networks and support.…”

Mental Health-Care Delivery for Older People in China: An Update of Challenges and Recent Clinical Research

“…To date, little is known about treatment status and patterns in older people with severe mental illness in China. Chen et al 21 examined the treatment status of older patients with schizophrenia, bipolar disorder, or major depressive disorder in rural areas of China and explored their associated factors. They used the Andersen's behavioral model, a theoretical framework for health services use in older population, which includes individual determinants of health service use: predisposing, enabling, and need.…”

Dietary Habits and Depression in Community-Dwelling Chinese Older Adults: Cross-Sectional Analysis of the Moderating Role of Physical Exercise

“…In addition, the accompanied high side effects of antidepressants can cause non-adherence, which was found to influence about 30% of depressed patients within 1 month and up to 60% within 3 months [ 9 ]. This is a major challenge and may worsen depressive symptoms or lead to other age-related diseases in older adults [ 10 ]. Therefore, optimizing clinically meaningful, non-pharmacological adjunctive therapies for depressed older adults will be important, considering the rapid population ageing and the consequent increasing healthcare demands [ 4 ].…”