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Hanipsych, beni suef, elderly with depression

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  • 1. Depression among elderly in Beni Suef city (Upper Egypt) Prof. Hani Hamed Dessoki, M.D.Psychiatry Prof. Psychiatry Chairman of Psychiatry Department.,Beni Suef University Supervisor of Psychiatry Department, El-Fayoum University Authors: Ekram M. El Shabrawy*, Hany H. El Desouky**, Eman El Tahlawy***, AlShymaa M. Lotfy**** *MD.Community medicine Department, Faculty of Medicine Beni Suef University **MD.Psychiatry Department, Faculty of Medicine Beni Suef University *** MD.Community medicine, National Research Center Cairo University ****M.B.B.Ch. Faculty of Medicine Beni Suef University
  • 2. Introduction Depression is a medical illness in which the person has feelings of sadness, discouragement and lack of selfworth, it can also be a sign of medical problem and may be complicated by brain disorders that occur with age, such as Alzheimer’s disease, it frequently goes without diagnosis and treatment .
  • 3. Introduction Studies have shown a positive correlation between age (especially 60 and older) and the presence of symptoms of depression . The depression risk increases among elderly living in nursing homes. Prevalence of depression in the nursing home population is very high, three to four times higher than in the community-dwelling elderly . Major depression in nursing-home population range from 10-22%.
  • 4. Introduction According to the results of census of population and housing facilities survey 2006 the proportion of the elderly in Egypt (population 60 years and above) amounted to about 6% of the total population, it is expected that the proportion of elderly population in Egypt will be about 9% by 2015 and then 12% by 2030. Egypt has its ingoing problems about elderly population. Beni Suef city was selected for the study as it is a Governorate of Upper Egypt about 130 KM South to Cairo. It is considered as one of the most deprived areas form health care services and this may be due to its geographical position near to Cairo. This issue encourages most health care consumers to travel to the nearby Cairo Governorate seeking for better level of Care .
  • 5. Objectives To find out the prevalence of depression among elderly in geriatric homes in Beni Suef city in comparison to those who live with their families and attending (geriatric club). To detect the underlying risk factors of depression.
  • 6. Subjects and Methods The study was conducted in Beni Suef city in three geriatric homes besides one geriatric club (the other two clubs were inactive), from December 2008 till October 2009. All the elderly above 60 years males and females who are living in geriatric homes and those attending the geriatric club were included (145) with the following Inclusion criteria: A: Those living in Beni Suef city, B: Alert and oriented to time, place and person.
  • 7. Subjects and Methods Data collection tools were: A questionnaire: pre-tested on a small scale pilot study, its results was not included. It contains, Socioeconomic data (age, sex, former occupation, martial status, educational level), Health condition (presence of chronic diseases as diabetes or hypertension). The used questionnaire was prepared in Arabic language to ensure that all participants will understand the questions
  • 8. Subjects and Methods Geriatric Depression Scale (GDS) (Arabic version). Selfrated 30-item scale which has been recommended by the Royal College of physicians, British Geriatric society as a suitable method for screening of depression in the geriatric age group and rating of its severity.
  • 9. Subjects and Methods Life Satisfaction Scale and Facing Daily Stressful Live Events Scale-Arabic version- It is a 30-statements scale that includes 3 subscales to which the subject agrees, disagrees or is equivocal. It was designed to give an idea about different strategies that can be used by the person to face and adapt different daily stressful life events (different coping skills).It was designed to assess the level of satisfaction about life. The higher score indicates higher level of satisfaction and comfort about life.
  • 10. Subjects and Methods Ethical considerations :All procedures of the study were conducted after explaining to the participants the study objectives, then consent was taken at first from director of place then the elderly and lastly from his family.
  • 11. Results 89.7 % of elderly in geriatric homes suffer from depression while only 56.7 % in geriatric clubs, the difference was statistically significant (p value < 0.0001) 77.8% of the females suffering from depression while it is only present in 67.4% of males (the difference was insignificant at p>0.05) There is no significant difference between depressed and normal elderly as regards educational level.
  • 12. Results Depression was present among 100% of single, 80.9% among divorced and the least among married 67.4%, (the difference was significant at p< 0.05)
  • 13. Results There is no statistical significant relation between occurrence of depression and family history of psychiatric disorder. Hypertension constitutes 51.9%, 43.2% while diabetes was present in 27.8% and 21.6% in the depressed and none depressed elderly respectively.
  • 14. Results There was statistical significant difference between the elderly in geriatric homes and clubs regarding the life satisfaction scales at p<0.00001 There was statistical significant negative correlation at p<0.0001 between the total geriatric depression scale and life satisfaction scale with controlling the place of living, all parameters of life satisfaction decrease with increasing the total depression score.
  • 15. Conclusion Depression among elderly is one of the most important public health problems. In Beni Suef city the depression among the elderly in geriatric homes were more than those living with their families and attending club. Depression is common with those who suffer from loneliness as single , widowed or divorced .There is no relation in occurrence of depression with education , sex or family history of depression , the people in geriatric homes cannot cope with stressful life events and not satisfied with their life . Depression has inverse relationship with the life events the more depression severity the less satisfaction with life.
  • 16. Recommendations There is a great need to increase the awareness among community about the importance of geriatric health and how depression is a silent disorder among geriatric group who need more love and care. There must be a social and health programs about the importance of family support for the elderly in our community that will save a lot of medical and hospital care cost , that is the expense for medical illness associated with depression.
  • 17. Recommendations Training of health care providers in the primary health care centers for identification of risk factors of depression , assessment of depression among elderly and providing services in a friendly manner. Geriatric depression assessment, guidance and support for any psychological and medical problem are priority services for elderly, also social relationships and activities are very important.
  • 18. Recommendations Psycho-education of the elderly Egyptians about the high incidence of depressive disorders in old age, presentation and the availability of adequate treatment with favorable outcome. Strengthen social relationships and activities besides encouraging visiting geriatric homes either by their families or the civil societies which are very important in preventing depression.