Regional and age differences in the reliability and factor structure of the SDS among elderly (65-84 years) men who were living either in eastern or in southwestern Finland were investigated. The Cronbach alpha coefficient was .803 for the eastern and .809 for the southwestern cohort; these figures were reasonably high. The tendency found was for the coefficient to be somewhat higher for the old (75-84 years) than for the young-old (65-74 years) population. In investigating the factor structure, a principal components factor analysis was performed, and the remaining factors were rotated using the orthogonal Varimax rotation algorithm. Three factors emerged for young-old men in the East, for young-old men in the Southwest and for old men in the Southwest, and four factors for old men in the East. The factor patterns of the first two factors showed similarities in both regions, but their order was different. "Loss of self-esteem" accounted for more of the common variance in the East and "agitated mood" in the Southwest. The differences in the third factor between the two regions were evident.
This community-based epidemiological survey concerns relationships between social and health factors and depression in a Finnish population aged 60 years or over. A multivariate analysis based on log-linear models is used in this study. The log-linear model showed five interactions for the depressed men and eight for the depressed women surveyed. These indicated that the depressive persons had experienced detrimental events either of an interpersonal nature or concerning health status more often than those who were not depressed. A positive connection between life stress and depression was found even though no cause-and-effect relationship could be defined. Social stress factors seemed somewhat important prior to the onset of depression in the women studied, whereas stressful health factors played a significant role for the men. Despite this, the log-linear models for the selected variables used here did not point to a combination of interactions between a high incidence of current social stress factors and a high incidence of stressful health factors during the six-month period prior to the onset of depression.
The study describes common symptoms of depression and age and sex differences in these symptoms in elderly Finns. The symptoms were assessed on the basis of the 22-item Hamilton Rating Scale for Depression (HRSD), and comparisons were made between the symptoms of those diagnosed as depressed and those diagnosed as not depressed in clinical investigations. The most common symptoms in depressed men were general somatic symptoms, initial insomnia, loss of interest in work and activities, middle insomnia, and depressed mood. In depressed women, the most common symptoms were psychic anxiety, general somatic symptoms, initial insomnia, loss of interest in work and activities, and depressed mood. In both these groups the lowest occurrences were found for compulsory symptoms, paranoid symptoms and depersonalization. The symptomatology was most severe in the oldest age group: depressed mood and many somatic symptoms were more common in depressed older male and female age groups than in younger groups. Sex comparisons showed that many symptoms were more severe in depressed women than in depressed men: depressed mood, feelings of guilt, psychic anxiety, somatic anxiety and diurnal variation of symptoms were more common in depressed women. Retardation was the only symptom that was more common in depressed men. Loss of libido did not belong to the symptomatology of depression in the oldest female age group, but in men and in younger female age group it could in some cases indicate occurrence of depression.
The study describes symptoms and signs of depression in elderly (60 years or over) Finns. Lists of symptoms and signs assessed by the examining physicians in a population study were used in rating, and the symptoms and signs of persons diagnosed as depressed were compared to those of persons who were not depressed. The commonest symptoms both in men and women were sleep disturbances, fatiguability, loss of interest, depressed mood, loss of activity, pains, pessimism and sense of uselessness. In addition, worry was a common symptom in women. Hallucinations and other delusions than those about unforgivable behaviour were very uncommon. Loss of libido did not strongly indicate occurrence of depression, and in persons aged 70 years or over it could not be included in symptoms of depression. Sex differences in the commonest symptoms of depression were evident: worry, crying spells, helplessness, loneliness, suicidal ideas and pains were more common in depressed women than in depressed men. Some age differences in symptoms were also found both in men and in women. Sad expression was a common sign of depression in both sexes. In addition, slow movements, scarcity of gestures and slow speech were quite common signs in depressed men and stooping posture was quite common in depressed women.
Social anxiety is a common problem in psychotic disorders. The Liebowitz Social Anxiety Scale, Self-Rating version (LSAS-SR) is a widely used instrument to capture different aspects of social anxiety, but its psychometric properties have not been tested in this patient group. The aims of the present study were to evaluate the psychometric properties of the LSAS-SR in patients with first episode psychosis, to investigate whether it differentiated between active and passive social withdrawal and to test which clinical factors contributed to current level of social anxiety.
A total of 144 first episode psychosis patients from the ongoing Thematically Organized Psychosis (TOP) study were included at the time of first treatment. Diagnoses were set according to the Structured Clinical Interview (SCID-1) for DSM-IV. A factor analysis was carried out and the relationship of social anxiety to psychotic and general symptomatology measured by the Positive and Negative Syndrome Scale (PANSS) was evaluated. Possible contributors to social anxiety were analyzed using multiple hierarchic regression analysis.
The factor analysis identified three subscales: public performance, social interaction and observation. All three subscales showed satisfactory psychometric properties, acceptable convergent and discriminate properties, and confirmed previous findings in social anxiety samples. Self-esteem explained a significant amount of the variance in social anxiety, even after adjusting for the effects of delusions, suspiciousness and depression.
The study shows that the LSAS-SR can be used in this patient group, that social anxiety is strongly related to both behavioral social avoidance and to self-esteem. The results support the use of this measure in assessment of social anxiety in both clinical settings and in research.
In a cross-sectional epidemiological study in Lieto, Finland, 61 men and 21 women with chronic obstructive pulmonary disease (COPD) were compared with age- and sex-matched controls from the same community to analyze the associations between COPD, cognitive performance, and occurrence of dementia. The cognitive assessment was based on the Mini-Mental State Examination (MMSE), previous clinical documents, and the assessment made by the research nurse after she had interviewed and tested each subject. These three measures revealed no differences between the COPD patients and the age-matched controls, and MMSE subtest scores did not differ significantly between the patients and controls. The findings suggest that the relative contribution of COPD to the occurrence of cognitive impairment and dementia in the elderly may be none or minimal at the community level.