Reliability, validity and factor structure of the CES-D in Iranian elderly

Objectives: In developing countries such as Iran, elder populations are growing. Due to the high prevalence of depressive disorders among elders, reliable screening instruments for this population are required. The main purpose of this study was to determine the reliability and validity of the Farsi version of the Center for Epidemiological Studies-Depression Scale-10 (CES-D) among Iranian elderly persons. Methods: The investigators created the Farsi version of the CES-D-10 by translation and back translation. Two hundred and four cases aged 59 and above completed the questionnaire. The reliability and validity of the translated CES-D-10 was established through comparison with the Composite International Diagnostic Interview (CIDI), a recognized gold standard method for diagnosing major depressive disorder. We used a receiver operating curve (ROC) to determine the optimum cutoff score. Results: The Farsi version of the CED-D-10 displayed acceptable psychometric characteristics, as reflected in internal consistency with Cronbach's alpha, split-half coefficients and test-retest reliability of 0.85, 0.65 and 0.49, respectively. Factor analysis and the varimax rotation resulted in two factors including 'depression' and 'interpersonal relationships'. The Depression factor (introduced as CES-D-8 of the scale) had significant correlation with the 10 items form (r=0.99) with 0.87 alpha coefficient. The ROC showed that the optimum cutoff point is 5 with sensitivity of 82 and specificity of 70, and positive and negative predictive values of 26 and 98, respectively, for both of the forms. Conclusion: Both the 10 and 8 items form of the Farsi version have desirable characteristics to be useful as a screening instrument for depressive disorders in Iranian elders, especially in urban areas. © 2015 Elsevier B.V.

Suicide in patients suffering from late-life anxiety disorders; a comparison with younger patients

Item does not contain fulltextBACKGROUND: Anxiety disorders are assumed to increase suicide risk, although confounding by comorbid psychiatric disorders may be one explanation. This study describes the characteristics of older patients with an anxiety disorder who died by suicide in comparison to younger patients. METHOD: A 15-year national clinical survey of all suicides in the UK (n = 25,128). Among the 4,481 older patients who died by suicide (>/= 60 years), 209 (4.7%) suffered from a primary anxiety disorder, and 533 (11.9%) from a comorbid anxiety disorder. Characteristics of older (n = 209) and younger (n = 773) patients with a primary anxiety disorder were compared by logistic regression adjusted for sex and living arrangement. Results : Compared to younger patients, older patients with a primary anxiety disorder were more often males and more often lived alone. Although 60% of older patients had a history of psychiatric admissions and 50% of deliberate self-harm, a history of self-harm, violence, and substance misuse was significantly less frequent compared to younger patients, whereas physical health problems and comorbid depressive illness were more common. Older patients were prescribed significantly more psychotropic drugs and received less psychotherapy compared to younger patients. CONCLUSION: Anxiety disorders are involved in one of every six older patients who died by suicide. Characteristics among patients who died by suicide show severe psychopathology, with a more prominent role for physical decline and social isolation compared to their younger counterparts. Moreover, treatment was less optimal in the elderly, suggesting ageism. These results shed light on the phenomenon of suicide in late-life anxiety disorder and suggest areas where prevention efforts might be focused

Rational points on some elliptic surfaces

Item does not contain fulltextBACKGROUND: Anxiety disorders are assumed to increase suicide risk, although confounding by comorbid psychiatric disorders may be one explanation. This study describes the characteristics of older patients with an anxiety disorder who died by suicide in comparison to younger patients. METHOD: A 15-year national clinical survey of all suicides in the UK (n = 25,128). Among the 4,481 older patients who died by suicide (>/= 60 years), 209 (4.7%) suffered from a primary anxiety disorder, and 533 (11.9%) from a comorbid anxiety disorder. Characteristics of older (n = 209) and younger (n = 773) patients with a primary anxiety disorder were compared by logistic regression adjusted for sex and living arrangement. Results : Compared to younger patients, older patients with a primary anxiety disorder were more often males and more often lived alone. Although 60% of older patients had a history of psychiatric admissions and 50% of deliberate self-harm, a history of self-harm, violence, and substance misuse was significantly less frequent compared to younger patients, whereas physical health problems and comorbid depressive illness were more common. Older patients were prescribed significantly more psychotropic drugs and received less psychotherapy compared to younger patients. CONCLUSION: Anxiety disorders are involved in one of every six older patients who died by suicide. Characteristics among patients who died by suicide show severe psychopathology, with a more prominent role for physical decline and social isolation compared to their younger counterparts. Moreover, treatment was less optimal in the elderly, suggesting ageism. These results shed light on the phenomenon of suicide in late-life anxiety disorder and suggest areas where prevention efforts might be focused