lecture 9

Question 1

Stereotypical images of older people

Answer 1

BBC News, 2013

• active golf club member, allotment keeper or busy grandparent
• lone pensioner, huddled in a chair by the fire trying to keep warm while using as little heat as possible who doesn’t see anyone for days

Question 2

what is good mental health?

Answer 2

Birren & Renner, 1980

• positive attitude toward self
• accurate perception of reality
• mastery of the environment
• autonomy
• personality balance
• growth and self-actualisation

Question 3

WHO, 2014

Answer 3

‘not merely absence of disease or infirmity’

Question 4

lifetime prevalence of DSM-IV disorders in National Comorbidity Survey

Answer 4

Kessler et al., 2015

• 60+ years had lower levels for all measures - anxiety, MDD, alcohol use, alcohol dependence
• 30-44 years highest in all

Question 5

prevalence of psychiatric disorder in 4 cohorts of community dwelling IS older adults

Answer 5

Reynolds et al., 2015
- prevalence decreases across all measures as they age
(mood disorder, anxiety disorder, substance use disorder, personality disorder)

Question 6

‘stiff upper lip’

Answer 6

Daily Mail, November, 2018
pensioners are three times more likely to hide any mental health conditions than younger people due to old school british ‘stiff upper lip’

Question 7

older adults and diagnosis

Answer 7

• likely to be more but haven’t asked for help - Local NHS data from 2016/17

Question 8

loneliness and mental health

Answer 8

Guardian, 2014 
- loneliness twice as unhealthy as obesity for older people 
Campaign to End Loneliness (2018) 
- loneliness increases risk of: 
cog decline and dementia 
depression 
suicidal behaviour

Question 9

does bereavement have a ‘special status’?

Answer 9

Kendler et al., 2018
- bereavement-related depression is similar to depression related to other stressful life events
- questions validity of bereavement exclusion criteria
Sikorski et al., 2014
- spousal bereavement associated with depressive symptoms but not major depressive disorder over time
- eliminating bereavement exclusion criterion unlikely to have effect on major depression as, prevalence is low

Question 10

barriers to assessment and treatment

Answer 10

Age UK report 2016
- unmet mental health needs of people in the uk
- lack joined up health care
37% of mental health trusts in England have no policies for providing integrated care to older people
- fewer over 65s being referred to IAPT services compared to the general population

Question 11

Stigma and mental health

Answer 11

Tzouvara et al., 2018
- public and self-stigma both identified in older people living with mental illness
manifested through fear, reluctance for social interaction, shame, secrecy and withdrawal
- insight into illness plays an important role in self-stigma experience