[Multiprofessional inpatient psychotherapy of depression in old age]

Three-dimensional psychological guidance combined with evidence-based health intervention in patients with liver abscess treated with ultrasound

BACKGROUND

Liver abscess is a common clinical liver disease mainly caused by suppurative bacteria or amoebae, with early clinical signs of chills, high fever, jaundice, and other symptoms. Establishing its early diagnosis is difficult, which may lead to misdiagnosis.

AIM

To observe the effects of psychological guidance combined with evidence-based health intervention in patients with liver abscess treated with ultrasound.

METHODS

A total of 120 patients with bacterial liver abscess admitted to our hospital from May 2018 to February 2021 were selected and divided into groups according to their intervention plan.

RESULTS

After the intervention, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Self-Perceived Burden Scale (SPBS), and quality of life scores (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, mental health) were lower than before the intervention in the two groups. The observation group had lower negative sentiment, SPBS, and quality of life scores than the control group. In the observation group, 31 and 24 patients had good and general compliance, respectively, with a compliance rate of 91.67%, which was significantly higher than that in the control group. The observation group had significantly lower total incidence of incision infection, abdominal abscess, hemorrhage, and severe abdominal pain than the control group.

CONCLUSION

Three-dimensional psychological guidance combined with evidence-based health intervention in treating liver abscess can reduce patients’ burden and negative emotions, improve patient compliance and quality of life, and reduce complications.

Low-Intensity Exercise as a Modifier of Depressive Symptoms and Self-Perceived Stress Level in Women with Metabolic Syndrome

The study aims to determine the impact of low-intensity exercise and psychoeducation on depressive symptoms and self-perceived stress in women with metabolic syndrome (MetS). Seventy-four women (mean age 69.35 ± 7.20) were included in the study. Participants were divided into two groups: those with MetS (n = 33) and those without MetS (n = 41). Subjects participated in low-intensity general-fitness exercise sessions combined with psychoeducation distributed regularly over a 12-week period. Participants completed the Geriatric Depression Scale-15 (GDS) and the Stress Level Questionnaire (SLQ) before and after the intervention. All investigated parameters significantly decreased for the participants with metabolic syndrome after the intervention. The level of GDS in this group decreased by approximately 37% (p < 0.01), and SLQ by around 23% (p < 0.01). Our results suggest, that low-intensity exercise combined with psychoeducation could lower depressive symptoms and stress level in women with MetS. However, the intervention does not lower anthropometric parameter scores.

[Psychotherapy of depressive disorders: Evidence in chronic depression and comorbidities]

BACKGROUND

Psychotherapy has been shown to be an effective treatment option for depressive disorders; however, its effectiveness varies depending on patient and therapist characteristics and the individual form of the depressive disorder.

OBJECTIVES

The aim of this article is to present the current evidence for psychotherapeutic antidepressive treatments for patients with chronic and treatment-resistant depression as well as for patients with mental and somatic comorbidities.

MATERIAL AND METHODS

During the revision of the currently valid German S3- and National Disease Management Guideline (NDMG) on unipolar depression published in 2015, a comprehensive and systematic evidence search including psychotherapy for specific patient groups was conducted. The results of this search along with a systematic update are summarized.

RESULTS

Psychotherapy has been shown to be effective in reducing depressive symptoms in patients suffering from chronic and treatment-resistant depression and in patients with mental and somatic comorbidities. The evidence is insufficient particularly for patients with mental comorbidities.

CONCLUSION

Based on the current evidence and clinical expertise the NDMG recommends psychotherapy alone or in combination with pharmacotherapy to treat most of these depressive patient groups. Evidence gaps were identified, which highlight the need for further research.

[Psychotherapeutic approaches for treatment of the elderly]

BACKGROUND

This article focusses on the possibilities, varieties, indications, and benefits of psychotherapy with elderly patients.

OBJECTIVE

Which basic principles can be differentiated, what theoretical rationales are helpful for psychotherapy with the elderly and what kind and forms of psychotherapy are available?

MATERIAL AND METHODS

Based on relevant references and research, clinically relevant and evidence-based psychotherapies are described, to understand the theoretical rationale, the goals, the procedure and main strategies.

RESULTS

Cognitive behavior therapy, problem solving therapy, life review therapy, interpersonal psychotherapy, and psychodynamic psychotherapy are available to treat various psychological and somatic problems in elderly patients. In particular, cognitive behavior therapy, problem solving therapy, and life review therapy are evidence-based and empirically validated. Evidence for interpersonal psychotherapy is mixed and for psychodynamic psychotherapy is missing.

CONCLUSION

Psychotherapy with old and very old patients is possible, well received, and successful. Age per se is no longer considered to be a relevant variable for indications of psychotherapy.