No abstract available.
Depression*

Rapid growth of the population of persons 65 years of age and older in Korea is projected to reach 7.1% of the total population by the year 2,000, and more than 13% by 2,020. Prevalence data for demented persons among the elderly vary, ranging from 7% to 10% of the population. Thus, the number of demented elderly will be about total 280,000 by the year 2,000. Most of the caring needs of the demented elderly have been fulfilled by female family members of the household, especially daughters-in-law. Recently women tend to engaged in social and job activities, and accordingly, caring for the demented elderly by the female family member will decrease, and caring for them by professional carers will increase. For setting desirable health care delivery systems for the elderly dementia, the authors presented four points that need to be considered. First, nationwide epidemiological studies for the prevalence of dementia are needed. The informations from epidemiology help give a more complete picture of the appropriate and accurate estimation of residential care facility for the dementia elderly. Second, programs for the care for, and management of patients with dementia in community settings are needed. More than two thirds of the dementia patients are mildly to moderately impaired in severity that can be managed in community setting. Third, organizations that perform diagnosis, evaluation and management of dementia, and organize comprehensive services for dementia patients is needed in community in which they live. Pre-existing organizations such as health center, or community mental health center, or new organization may be considered. Fourth, centers that play a role in educating dementia-related personnel, making and evaluating of programs for the management of dementia every year is needed. A central center should be placed in every province, and it should be connected to one another functionally.
Aged ; Caregivers ; Delivery of Health Care* ; Dementia* ; Diagnosis ; Epidemiology ; Family Characteristics ; Female ; Humans ; Korea* ; Mental Health ; Prevalence

Depression, dementia, and other psychiatric disorders of the aged persons are usually chronic and recurrent. These make the daily lives of the eldrly very troublesome. These mental disorders will demand more and more attention from the elderly health care systems. Dementia is present in 6.26-11.3% of Korean elderly. Prevalence of Alzheimer's type is 4.17-5.3%, and that of the vascular dementia is 1.05-2.5%. Prevalence of major depressive disorder in the elderly aged 65 years and older is 4.2-7.5%, and that of dysthymic disorder is 2.0-3.9%. Depressive symptoms are reported up to 7-23.5% of older adults according to the survey methods and sample groups. Alcoholism, sleep disorders and other mental health related conditions are also important concerns but have not been as well studied as depression and dementia. In this review, we examined the prevalence and incidence of major mental disorders based on the national epidemiological data of Korean elderly. Therefore we hope that this perspective gives supports to the development of educational plans of geriatric psychiatry. And, hopefully, the present data help the government and NGOs establish and promote the policy for the health of the aged population.
Adult ; Aged* ; Alcoholism ; Surveys and Questionnaires ; Delivery of Health Care ; Dementia ; Dementia, Vascular ; Depression ; Depressive Disorder, Major ; Dysthymic Disorder ; Geriatric Psychiatry ; Hope ; Humans ; Incidence ; Mental Disorders ; Mental Health ; Prevalence ; Sleep Wake Disorders

OBJECTIVES: This study is to evaluate the prevalence, incidence, and risk factors of cognitive impairment and depression in the elderly in community. METHODS: This study was a one-year follow-up of Yonchon cohort aged 65 years and over, selected initially in a prevalence study of dementia and depression. A sample of 790 elderly persons who completely interviewed in a prevalence study was re-interviewed with one year interval using the Korean version of Psychogeriatric Assessment Scale (K-PAS). RESULTS: A total of 631 elderly persons was completely interviewed in this follow-up study. The prevalence of cognitive impairment and depression were 21.4% (11.9% in males and 28.3% in females) and 8.4% (6.3% in males and 10.0% in females), respectively. The one-year incidence of cognitive impairment and depression were 11.4% (5.7% in males and 16.2% in females) and 5.1% (3.1% in males and 6.6% in females), respectively. The risk factors of the prevalence of cognitive impairment were education, age, sex, history of stroke, and economic status. The risk factors of the prevalence of depression were family history of depression, history of stroke, marital status, and economic status. The risk factors of the incidence of cognitive impairment were female gander, education, age, alcohol use disorder, marital status, and economic status. The risk factors of the incidence of depression were low education, disrupted marital status, and poor economic status. CONCLUSION: Cognitive impairment and depression were frequent in the elderly. Several risk factors for cognitive impairment and depression were identified. These results suggest that comprehensive health and social services were needed for the elderly.
Aged* ; Cohort Studies ; Cross-Sectional Studies ; Dementia* ; Depression ; Depressive Disorder* ; Education ; Female ; Follow-Up Studies* ; Humans ; Incidence* ; Male ; Marital Status ; Prevalence* ; Risk Factors* ; Social Work ; Stroke

We have not yet had any official diagnostic system of mental disorders that is specific for the elderly patients. As in other diagnostic categories, the DSM-IV and ICD-10 are used as the official diagnostic criteria for mood disorder. Several dichotomous classifications are, however, applied sometimes for clinical and research convenience. The reported prevalence rates of depressive symptoms are between 10-40% among the elderly residing in community;the rate is far higher among those who are hospitalized or in chronic institution. The prevalence of major depression, clinical depression, among the elderly is known to be lower than that among younger adults, the exact reason for which is not well clarified so far. The rate of dysthymia is around 1.7% and similar to that for general population. Poor social support network is the most well known risk for developing depression for the elderly.
Adult ; Aged ; Classification* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology* ; Humans ; International Classification of Diseases ; Mental Disorders ; Mood Disorders ; Prevalence

We have not yet had any official diagnostic system of mental disorders that is specific for the elderly patients. As in other diagnostic categories, the DSM-IV and ICD-10 are used as the official diagnostic criteria for mood disorder. Several dichotomous classifications are, however, applied sometimes for clinical and research convenience. The reported prevalence rates of depressive symptoms are between 10-40% among the elderly residing in community;the rate is far higher among those who are hospitalized or in chronic institution. The prevalence of major depression, clinical depression, among the elderly is known to be lower than that among younger adults, the exact reason for which is not well clarified so far. The rate of dysthymia is around 1.7% and similar to that for general population. Poor social support network is the most well known risk for developing depression for the elderly.
Adult ; Aged ; Classification* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology* ; Humans ; International Classification of Diseases ; Mental Disorders ; Mood Disorders ; Prevalence

OBJECTIVE: This study aims to access the distributions of psychiatric disorders in a community population using the Korean version of Composite International Diagnostic Interview(K-CIDI). METHODS: CIDI is a comprehensive, fully standardized interview suitable for epidemiologic study. Subjects were selected by taking two-stage, cluster samples of 1,763 adult household residents, 18 to 64 years of age, in Namyangjusi, Kyunggido. Ten trained interviewers administered the K-CIDI to the selected respondents, from July 1 to August 30, 1999. RESULTS: Total 1,060 respondents completed the interview. Lifetime prevalences and male/female ratio of lifetime prevalences of alcohol use disorders(abuse/dependence), nicotine dependence, specific phobia, major depressive disorder, and posttraumatic stress disorder were 15.6%(6.8%/8.9%) and 5.8 (12.3/3.7), 5.7% and 5.5, 3.9% and 0.3, 3.3% and 0.4, and 1.5% and 0.6, respectively. One-year prevalences and male/female ratio of one-year prevalences of alcohol use disorders, nicotine dependence, specific phobia, major depressive disorder were 7.5% and 6.8, 3.8% and 5.3, 3.4% and 0.4, and 2.0% and 0.3, respectively. CONCLUSION: Compared with previous Korean results, the prevalence of alcohol use disorder was decreased and the prevalence of major depressive disorder showed little change. The prevalence of alcohol use disorder was comparable with the results of other countries, whereas mood disorders and anxiety disorders were less frequent than in other countries. Remarkable differences of distributions of psychiatric disorders across the areas and times were observed. Systematic cross-cultural comparison study is needed to overcome the methodological problems and to explore the cause of differences of distributions of psychiatric disorders.
Adult ; Anxiety Disorders ; Cross-Cultural Comparison ; Surveys and Questionnaires ; Depressive Disorder, Major ; Epidemiologic Studies ; Epidemiology ; Family Characteristics ; Gyeonggi-do ; Humans ; Mood Disorders ; Phobic Disorders ; Prevalence* ; Stress Disorders, Post-Traumatic ; Tobacco Use Disorder

In psychiatry, the remission of diseases and the recovery of disabilities have been the critical points of treatment. And the scales which evaluate the functions and disabilities of patients were needed to see the remission of diseases and the recovery of disabilities. Among these functional scales, Global Assessment of Functioning Scale (GAF) and Social and Occupational Functioning Scale (SOFAS) were widely used to indicate psychosocial functions. GAF and SOFAS are 100 point single-item global scale to evaluate the functions of patients, and have advantages to apply in short time. And these scales have high reliability, predict the course of subjects, and reflect the patients' changes sensitively. Therefore, these scales were used frequently in clinical situation. To use GAF more effectively, clinician training and constructive use of GAF-total, GAF-symptom, and GAF-disability are needed.
Disability Evaluation ; Humans ; Weights and Measures

OBJECTIVE: The question of whether religion has beneficial or detrimental effects on the mental well-being of the adult individual is debatable. Because most Korean citizens are free to select their own religion, there is a higher proportion of non-believers than believers among the Korean population. The aim of this research was to investigate the association between spiritual values and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mental disorders in Korea across all types of belief systems, including Koreans not affiliated with a particular religion. METHODS: The Korean version of the Composite International Diagnostic Interview 2.1 was used to interview 6,275 people across South Korea in 2001. While controlling for age and sex, we used logistic regression to analyze the relationship between mental disorders (both current and past) and the types of religion and spiritual values. RESULTS: Strong spiritual values were positively associated with increased rates of current depressive disorder and decreased rates of current alcohol use disorder. Using "atheist" as the reference category, Catholics had higher lifetime odds of single episodes of depression whilst Protestants had higher lifetime odds of anxiety disorder and lower lifetime odds of alcohol use disorders. CONCLUSION: The results of this study suggest that depressive episodes often lead to a search for spirituality and that religion may be helpful in overcoming depression or becoming less vulnerable to relapsing. The associations between religion, spiritual values, and mental health have not been fully elucidated and warrant further exploration.
Adult ; Anxiety Disorders ; Depression ; Depressive Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Logistic Models ; Mental Disorders ; Mental Health ; Prevalence ; Protestantism ; Republic of Korea ; Spirituality

OBJECTIVES: The aim of this study was to investigate mortality rates and risk factors in dementia patients in a rural cohort. METHODS: A total of 114 subjects with clinically diagnosed dementia were followed up for eight years from 1997 to 2005. Their mortality was compared with sociodemographic and clinical variables using the Cox proportional hazards models after adjusting age, sex, and education. RESULTS: During follow-up, the mortality rate of subjects was 80.2% and the mean (SD) duration of survival from at diagnosis to death was 4 years. Mortality in subjects with dementia depended on old age (relative risk [RR] : 1.05 ; 95% confidence interval [CI] : 1.01-1.08), male (RR : 1.61 ; CI : 1.00-2.59), low Clinical Dementia Rating scale (RR : 1.54 ; CI : 1.14-2.10), low Activities of Daily Living (RR : 0.72 ; CI : 0.59-0.89), low Instrumental Activities of Daily Living (RR : 0.83 ; CI : 0.75-0.92), no physical activity (RR : 0.44 ; CI : 0.28-0.70), smoking (RR : 1.74 ; CI : 1.05-2.89). CONCLUSION: Mortality in dementia depended on age, sex, CDR, ADL, IADL, physical activity, smoking. These findings have important implications that contribute to make the disease management of dementia patients.
Activities of Daily Living ; Cohort Studies ; Dementia* ; Diagnosis ; Disease Management ; Education ; Follow-Up Studies ; Humans ; Male ; Mortality* ; Motor Activity ; Proportional Hazards Models ; Risk Factors* ; Smoke ; Smoking