Identifying Psychological Distress in Elderly Seeking Health Care.
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Date
2015-01
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Abstract
Background: Psychological distress in the elderly with various illness conditions often goes unrecognized. Since
psychological distress is treatable, it is important to recognize it at the earliest to enhance recovery. This is an interim
analysis of screening data of the elderly seeking health care in a hospital in India, with a focus on the 12-item General
Health Questionnaire (GHQ-12), a screening instrument for psychological distress and a rationale for a higher cutoff
score in help seeking elderly. Materials and Methods: A retrospective analysis of screening data of psychological
distress using GHQ-12 in the elderly seeking care for neuropsychiatric conditions was carried out. Traditionally, ≥2
is considered positive for distress by GHQ-12. Receiver Operating Characteristic (ROC) curve was used to define
new cutoff points for psychological distress. Results: At ≥2, 2443 (50%) of the elderly screened were recognized to
be psychologically distressed. Using an ROC and optimum sensitivity and specificity measures, a cutoff score of ≥4
was observed to detect 30% of the elderly who had diagnosable mental health disorders. Female sex, illiteracy, and
multiple co-morbidities were the factors that were associated with higher cutoff scores on GHQ-12 proposed here
and psychiatric morbidity thereof. Conclusion: There is greater psychological distress among the elderly seeking
health care. Hence, it is important to screen them and identify those at higher risk. Using a higher cutoff score with
a standardized instrument like GHQ-12 indicated that it was statistically valid to identify those elderly with higher
distress in a busy out-patient setting.
Description
Keywords
Elderly, Psychological distress, Screening instrument
Citation
Shivakumar Prafulla, Sadanand Shilpa, Bharath Srikala, Girish N, Varghese Mathew. Identifying Psychological Distress in Elderly Seeking Health Care. Indian Journal of Public Health. 2015 Jan-Mar; 59(1): 18-23.