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Source
Can Med Assoc J. 1980 Mar 8;122(5):525-32, 540
Publication Type
Article
Date
Mar-8-1980
Author
D. Wasylenki
Source
Can Med Assoc J. 1980 Mar 8;122(5):525-32, 540
Date
Mar-8-1980
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Antidepressive Agents, Tricyclic - therapeutic use
Brain Chemistry
Canada
Delirium, Dementia, Amnestic, Cognitive Disorders - diagnosis
Dementia - diagnosis
Depression - classification - diagnosis - epidemiology - physiopathology - therapy
Diagnosis, Differential
Electroconvulsive Therapy
Female
Grief
Humans
Male
Psychophysiologic Disorders - etiology
Psychotherapy
Self Concept
Sex Factors
Social Isolation
Suicide - epidemiology
Abstract
Depression in the elderly is very common and may be difficult to diagnose. Because of its varied presentation and its frequent association with physical illness it will be encountered increasingly by all physicians as the elderly population expands. Depression, though treatable, is often not treated, and suicide rates are high among depressed elderly persons. Diagnostic difficulties lie in distinguishing depression from organic brain syndromes, from so-called masked depressions and from normal grief reactions. Pharmacologic treatment is effective, but care must be taken to recognize side effects and to use adequate doses. Psychologic approaches should focus on reducing feelings of helplessness and failing self-esteem. The importance of the losses borne by elderly persons in the pathogenesis of depression continues to be of theoretical and practical interest.
Notes
Cites: Am J Psychother. 1967 Oct;21(4):791-66065663
Cites: Br J Psychiatry. 1967 Nov;113(504):1237-644169954
Cites: Int Rev Neurobiol. 1970;12:145-754918142
Cites: Arch Gen Psychiatry. 1972 Sep;27(3):312-75051619
Cites: Lancet. 1972 Sep 23;2(7778):632-54116781
Cites: Lancet. 1972 Nov 11;2(7785):999-10024116985
Cites: Annu Rev Pharmacol. 1973;13:427-544197470
Cites: Psychiatr Neurol Neurochir. 1973 Nov-Dec;76(6):489-5004781526
Cites: Arch Gen Psychiatry. 1974 Nov;31(5):665-724441239
Cites: Arch Gen Psychiatry. 1975 Apr;32(4):439-431119897
Cites: Arch Gen Psychiatry. 1975 Mar;32(3):285-3051092281
Cites: Am J Psychiatry. 1975 Sep;132(9):893-9001098483
Cites: Arch Gen Psychiatry. 1975 Sep;32(9):1087-93241308
Cites: Arch Gen Psychiatry. 1976 Mar;33(3):347-50769725
Cites: J Gerontol. 1976 May;31(3):278-821270761
Cites: J Gerontol. 1976 May;31(3):283-921270762
Cites: J Gerontol. 1976 May;31(3):293-91270763
Cites: J Gerontol. 1976 May;31(3):300-31270764
Cites: J Gerontol. 1976 May;31(3):311-31270765
Cites: Arch Gen Psychiatry. 1976 Dec;33(12):1479-89793564
Cites: Br J Psychiatry. 1977 Jan;130:1-18831901
Cites: J Gerontol. 1977 May;32(3):299-302850057
Cites: Can Psychiatr Assoc J. 1976 Dec;21(8):527-311024694
Cites: Am J Psychother. 1978 Jan;32(1):5-19655307
Cites: Am J Psychother. 1978 Jan;32(1):93-104655309
Cites: Arch Gen Psychiatry. 1977 Dec;34(12):1450-4263815
Cites: Am J Psychiatry. 1951 Oct;108(4):289-9414868799
Cites: Am J Psychiatry. 1953 Jun;109(12):916-2113050818
Cites: Am J Psychiatry. 1955 Jun;111(12):896-90114376657
Cites: Psychoanal Rev. 1955 Oct;42(4):419-2713273553
Cites: Br J Psychiatry. 1965 Aug;111:687-9014337416
PubMed ID
6989463 View in PubMed
Less detail

From hospital to community. Six-month and two-year outcomes for 505 patients.

https://arctichealth.org/en/permalink/ahliterature239964
Source
J Nerv Ment Dis. 1984 Nov;172(11):667-73
Publication Type
Article
Date
Nov-1984
Author
P. Goering
D. Wasylenki
W. Lancee
S J Freeman
Source
J Nerv Ment Dis. 1984 Nov;172(11):667-73
Date
Nov-1984
Language
English
Publication Type
Article
Keywords
Academies and Institutes
Adult
Aftercare - standards
Attitude to Health
Canada
Delivery of Health Care - standards
Employment
Female
Follow-Up Studies
Hospitals, General
Hospitals, State
Humans
Male
Mental Disorders - psychology - rehabilitation - therapy
Middle Aged
Outcome and Process Assessment (Health Care)
Patient Discharge - standards
Patient Readmission
Psychiatric Status Rating Scales
Residence Characteristics
Social Adjustment
Abstract
The authors have completed a large descriptive study of the system of psychiatric aftercare in Metropolitan Toronto. This article describes the relevant 6-month and 2-year postdischarge outcome in each of five aftercare components for 505 subjects in a traditional system of service delivery. Provincial hospital, research institute, and general hospital subgroups are compared. For the total group, recidivism and employment rates are similar to those found in previous studies. Symptoms and distress levels are high. Considerable numbers of subjects live in inadequate and unsatisfactory housing. Social isolation, inadequate income, and difficulties with instrumental role functioning are persistent problems with little improvement between 6 months and 2 years postdischarge. Differences among the subgroups vary according to type of outcome and, for the most part, can be explained by differences in the characteristics of the patients served by the three types of inpatient treatment settings. These findings provide additional information about serious deficiencies in discharge planning and aftercare service delivery that is focused primarily upon the treatment of illness. The authors conclude that a more balanced system of aftercare requires a shift in resources to rehabilitation programs in the community.
PubMed ID
6092532 View in PubMed
Less detail

Gender differences among clients of a case management program for the homeless.

https://arctichealth.org/en/permalink/ahliterature224394
Source
Hosp Community Psychiatry. 1992 Feb;43(2):160-5
Publication Type
Article
Date
Feb-1992
Author
P. Goering
D. Wasylenki
M S Onge
D. Paduchak
W. Lancee
Author Affiliation
Health Systems Research Unit, Clarke Institute of Psychiatry, Toronto, Ontario, Canada.
Source
Hosp Community Psychiatry. 1992 Feb;43(2):160-5
Date
Feb-1992
Language
English
Publication Type
Article
Keywords
Adult
Aged
Community Mental Health Services - utilization
Cross-Sectional Studies
Disability Evaluation
Female
Follow-Up Studies
Homeless Persons - psychology - statistics & numerical data
Humans
Incidence
Male
Managed Care Programs - utilization
Mental Disorders - epidemiology - psychology - rehabilitation
Middle Aged
Ontario - epidemiology
Psychiatric Status Rating Scales
Psychotic Disorders - epidemiology - psychology - rehabilitation
Rehabilitation, Vocational - utilization
Sex Factors
Abstract
Differences between 24 female and 35 male clients were assessed at entry into an intensive case management program serving homeless shelter residents and again nine months later. Both men and women were socially isolated, with small social networks and severe deficits in social functioning. Histories of homelessness were similar for both genders, and there were no gender differences in psychopathology at baseline or follow-up. At entry into the program women had higher levels of social skills, larger and more supportive networks, and better housing conditions than men, but these differences disappeared after the subjects spent nine months in the program. Inadequate living conditions may have contributed to the more negative initial picture for men. Although there were more similarities than differences between the men and women in this sample, more research on gender differences is needed to design and evaluate programs for homeless mentally ill persons.
PubMed ID
1572613 View in PubMed
Less detail

A home-based program for the treatment of acute psychosis.

https://arctichealth.org/en/permalink/ahliterature208857
Source
Community Ment Health J. 1997 Apr;33(2):151-62; discussion 163-5
Publication Type
Article
Date
Apr-1997
Author
D. Wasylenki
M. Gehrs
P. Goering
B. Toner
Author Affiliation
Continuing Care Division, Clarke Institute of Psychiatry, Toronto, Ontario.
Source
Community Ment Health J. 1997 Apr;33(2):151-62; discussion 163-5
Date
Apr-1997
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Comorbidity
Cost Savings
Cost of Illness
Female
Home Care Services, Hospital-Based - economics
Humans
Male
Middle Aged
Ontario
Paranoid Disorders - economics - psychology - rehabilitation
Patient Admission - economics
Patient Care Team - economics
Psychotic Disorders - economics - psychology - rehabilitation
Schizophrenia - economics - rehabilitation
Schizophrenic Psychology
Substance-Related Disorders - economics - psychology - rehabilitation
Treatment Outcome
Abstract
There is evidence that home treatment is an effective alternative to hospital admission for patients with acute psychiatric illnesses. This report describes processes necessary to establish and disseminate home treatment programs as well as the impact and comparative cost of a home treatment program developed in Metropolitan Toronto. Organizational analysis revealed a number of essential structures and interactions necessary to facilitate smooth functioning for home treatment programs involving several agencies. Attitudes towards home treatment were positive, symptoms were reduced, family burden decreased, satisfaction was high and home treatment was preferred to hospital admission. Economic data indicate that home treatment is less costly than hospitalization.
PubMed ID
9145257 View in PubMed
Less detail

Mood disorders: rural/urban differences in prevalence, health care utilization, and disability in Ontario.

https://arctichealth.org/en/permalink/ahliterature212117
Source
J Affect Disord. 1996 Apr 26;38(1):57-65
Publication Type
Article
Date
Apr-26-1996
Author
S V Parikh
D. Wasylenki
P. Goering
J. Wong
Author Affiliation
Clarke Institute of Psychiatry, Toronto, Ont., Canada.
Source
J Affect Disord. 1996 Apr 26;38(1):57-65
Date
Apr-26-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Bipolar Disorder - epidemiology
Comorbidity
Cross-Sectional Studies
Depressive Disorder - epidemiology
Disabled Persons - psychology - statistics & numerical data
Female
Health Resources - utilization
Humans
Incidence
Male
Middle Aged
Ontario - epidemiology
Rural Population - statistics & numerical data
Urban Population - statistics & numerical data
Abstract
This study examines whether rural Ontario differs from urban Ontario in mood disorder prevalence, health service use and concomitant disability. An epidemiologic community survey of 9953 individuals was conducted, with rural/urban status defined by population-density-related criteria. Overall, Ontario prevalence rates for depression, manic episode, and dysthymia were similar to previous studies, but rural rates were unexpectedly no different from urban ones. Nearly half of mood disorder subjects used no services, and one-third reported significant disability. Rural individuals with mood disorders were similar to their urban counterparts in service use and disability.
PubMed ID
8735159 View in PubMed
Less detail

Planning mental health services: background and key issues.

https://arctichealth.org/en/permalink/ahliterature219135
Source
New Dir Ment Health Serv. 1994;(61):21-9
Publication Type
Article
Date
1994
Author
D. Wasylenki
P. Goering
E. Macnaughton
Author Affiliation
University of Toronto.
Source
New Dir Ment Health Serv. 1994;(61):21-9
Date
1994
Language
English
Publication Type
Article
Keywords
Canada
Community Mental Health Services - utilization
Delivery of Health Care
Health planning
Humans
Mental Disorders - complications
Mental Health Services - organization & administration - utilization
Substance-Related Disorders - complications
Abstract
Deinstitutionalization in Canada produced a shift in locus of care from provincial psychiatric hospitals to general hospital psychiatric units. As a result of this approach, a number of key planning issues have emerged that most provinces are attempting to address.
PubMed ID
8208226 View in PubMed
Less detail

Planning mental health services: current Canadian initiatives.

https://arctichealth.org/en/permalink/ahliterature219133
Source
New Dir Ment Health Serv. 1994;(61):31-40
Publication Type
Article
Date
1994

Planning mental health services: I. Background and key issues.

https://arctichealth.org/en/permalink/ahliterature224017
Source
Can J Psychiatry. 1992 Apr;37(3):199-206
Publication Type
Article
Date
Apr-1992
Author
D. Wasylenki
P. Goering
E. Macnaughton
Author Affiliation
Continuing Care Division, Clarke Institute of Psychiatry, Toronto, Ontario.
Source
Can J Psychiatry. 1992 Apr;37(3):199-206
Date
Apr-1992
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Canada - epidemiology
Community Mental Health Services - trends
Cross-Sectional Studies
Deinstitutionalization - trends
Health planning - trends
Health Services Needs and Demand - trends
Humans
Incidence
Mental Disorders - epidemiology - psychology - rehabilitation
Abstract
Planning mental health services is a complex task requiring an understanding of background developments and key issues related to mental health services. In Canada, the deinstitutionalization of patients attempted to shift the locus of care from provincial psychiatric hospitals to general hospital psychiatric units. This resulted in the isolation of provincial psychiatric hospitals, general hospital psychiatric units and community mental health programs, with little overall accountability for the services provided--three solitudes. To move toward the creation of responsible, integrated systems a number of issues must be addressed: target population(s); the roles of provincial psychiatric and general hospitals; community support services; continuity of care; co-morbidity; consumerism; and methods of integration. In the development of a comprehensive mental health plan, each issue should be recognized and decisions made which are in keeping with current knowledge. A companion report will survey Canadian initiatives in mental health planning and discuss approaches to many of the issues identified.
PubMed ID
1591672 View in PubMed
Less detail

Planning mental health services: II. Current Canadian initiatives.

https://arctichealth.org/en/permalink/ahliterature223830
Source
Can J Psychiatry. 1992 May;37(4):259-63
Publication Type
Article
Date
May-1992
Author
P. Goering
D. Wasylenki
E. Macnaughton
Author Affiliation
Health Systems Research Unit, Clarke Institute of Psychiatry, Toronto, Ontario.
Source
Can J Psychiatry. 1992 May;37(4):259-63
Date
May-1992
Language
English
Publication Type
Article
Keywords
Canada
Community Mental Health Services - trends
Continuity of Patient Care - trends
Health planning - trends
Health Policy - trends
Health Services Needs and Demand - trends
Humans
Mental Disorders - rehabilitation
Abstract
A brief overview of recent policy developments across Canada and a discussion of the common themes and challenges they address demonstrates the scope of activity in this field. The federal level of mental health planning and a summary of recent of policy developments in each province are described. Significant progress has been made in Canada in the development of mental health services since deinstitutionalization. Major challenges remain, however, which are being addressed to varying degrees across the country. The challenges related to the key issues of major mental illness, integration and consumerism are illustrated.
PubMed ID
1611587 View in PubMed
Less detail

14 records – page 1 of 2.