Telepsychiatry:The Evaluation and Treatment of Seniors in Rural Retirement Communities

• 作者: Robert Gallop Susanne Inez Steinberg
• 来源期刊: 老年医学(英文)
• 学科: 医学
• 关键词: PSYCHOTHERAPY PSYCHOPHARMACOLOGY TELEPSYCHIATRY SENIORS Retirement communities Nursing Homes
• 年，卷（期）: 2019,（2）
• 页码范围: 23-31
• 页数: 9页
• 分类号: R74

摘要

Few studies examine the benefits from geriatric telepsychiatry in rural retirement communities.Objectives:1.To demonstrate that using telepsychiatry(a)standard approaches to psychiatric evaluation would yield diagnoses in Diagnostic and Statistical Manual of Mental Disorders(DSM-V);(b)psychotherapies and pharmacotherapy could be effectively administered.2.To examine the relationships among cognition,mood,agitation and functions at baseline and the response to treatment over time.Design:Prospective longitudinal study.Measures:Geriatric Depression scale(GDS),Mini Mental State Exam(MMSE),Barthel Index(BI),Pittsburgh Agitation Scale(PAS).Setting:Video Teleconferencing.Interventions:Psychotherapy,psychopharmacology.Participants:428 Seniors over 55,met criteria for at least one DSM-V diagnosis.Results:Treatments were administered for a full range of psychiatric diagnoses and age-related medical conditions.The most frequently prescribed pharmacological agents were:antidepressants(78%)antipsychotics(64%),memory enhancers(38%).Participants(66%)received psychotherapy:individual(31%),couple(7%),family(13%).Variation in the MMSE scores were observed:55%remained stable,11%declined,18%improved.GDS Scores improved from baseline to 26 weeks(p=0.02,d=0.99:95%CI 0.39-1.56).PAS scores declined from baseline to 52 weeks(McNemar’s S=11.27,p=0.0008,d=1.17:95%CI 0.63-1.68).Function(BI)at week 26 was not statistically significantly different from baseline(t(26)=1.66,p=0.11,d=0.65:95%CI-0.16-1.42).Participants maintained independence(64.5%)at 52 weeks(McNemar’s S=6.23,p=0.013,d=0.79:95%CI 0.19-1.36)Conclusion:This study demonstrates the feasibility and benefit of providing a full complement of services via telepsychiatry to seniors and provides a rationale for more comprehensive reimbursement plans.