Introduction
Growth of elderly population is growing continuously and it is projected that by the year 2025 majority of the elderly people worldwide will be residing in developing countries. India is amidst a demographic transition with a trend towards an ageing population. In India ageing population above 60 years has been estimated to almost double-up from 7.7% in 2001 to 12.3% in 2025 and number of elderly people will be nearly 150 million worldwide.1
The elderly are more vulnerable to disease because of impaired physiological functions and defence mechanism. It is reported that, 45% of elderly suffer from chronic illness. Hence the aim of the study is to evaluate their psychiatric and associated diseases so that they can be highlighted and treated efficiently.
Materials and Methods
60 retired (aged) people regularly visiting psychiatric outpatient department (OPD) of IIMS & R warudi. Badnapur (tq) Jalna (dist) – Maharashtra – 431202 were studied.
Inclusion criteria
Patients having major depression suicidal ideation or attempt, paranoid reaction, anxiety were selected.
Exclusion criteria
The patients having severe malnutrition, pre and post-surgical depression, malignancy, cardio-vascular diseases, immuno – compromised patients were excluded from study.
Ethical approval
This research paper was approved by Ethical committee of IIMS and R warudi, Badnapur (Tq), Jalna (Dist.), - 431202 Maharashtra.
Method
Majority of the patients referred by physician (Medicine department) medico social worker or general practitioner.
Every patient was undergone, psychiatric counselling and diagnosed type of illness. Their past history was also noted and treated accordingly. If previous medication of anti-psychiatry was also noted.
Duration of study was July-2021 to May-2021.
Discussion
In the present study of depressive illness in retired persons in Maharashtra they had 23 (38.3%) dementia, 14(28.3%) major depression, 11(18.3%) manic, 8(13.3%) anxiety, 4(6.6%) paranoid (Table 1). The disease associated depressive illness were – 14(23.3%), 21(35%) osteoarthritis, 8(13.3%) had visual problems, 10(16.6%) had constipation (Table 2). The social or family problem included were – 17(21.6%) family conflicts, 13(21.6%) death of life partner or close relative, 9(15%) sudden loss of job or business, 21(35%) loneliness (Table 3). 38(61.2%) had suicidal ideation, 22(36.6%) had attempt for suicide (Table 4). These findings are more or less in agreement with previous studies. 2
Emotional and mental illness escalate over the course of life. Depression and hypochondriasis commonly accompany many physical ailment of old age. Organic brain disorders also show increased incidence in old age. Depression significantly affects the functional status in ill elderly patients. Depressive symptoms occur in 50% of persons aged 65 and above in the community. Patients with medical illness are known to have high prevalence of co-morbid depression as the concurrent physical illness increase the vulnerability to mental health illness. 3 The rates of depressive disorders amongst hospitalised elderly have been reported to be ten times greater. Also the depressive disorders are inadequately diagnosed more so in the elderly with medical problems. In a study among all the geriatric clinic attendees 23% of patients had depressive symptoms and 18% had a definitive depressive disorders but surprisingly none of the geriatric physician could diagnose depression among them.4 In addition, advancing age is often accompanied by loss of key social support system due to the death of spouse or siblings, retirement and/or relocation of residence, there may be delaying in the effective treatment. Epidemiological and clinical studies consistently indicate that depression adversely affects the lives of older adults. The confounding relationship between atypical phenomenology of depression in elderly and the co-occurrence of physical illness influences both diagnosis and treatments presenting unique clinical and therapeutic challenge. 5 Hence while treating elderly patient’s depressive illness must be taken into consideration.
Table 1
Study of different diseases of depressive psychiatric illness in Retired people.
|
S.No. |
Depressive illness |
No of patients (60) |
Percentage (%) |
|
1 |
Dementia |
23 |
38.3 |
|
2 |
Major Depression |
14 |
23.3 |
|
3 |
Manic |
11 |
18.3 |
|
4 |
Anxiety |
08 |
13.3 |
|
5 |
Paranoid |
04 |
6.6 |
Table 2
Diseases associated depressive illness.
|
S.No. |
Associated Diseases |
No of patients (60) |
Percentage (%) |
|
1 |
Diabetic Mellitus |
14 |
23.3 |
|
2 |
Osteoarthritis |
21 |
35 |
|
3 |
Vertigo |
8 |
13.3 |
|
4 |
Visual Problems |
7 |
11.6 |
|
5 |
Constipation |
10 |
16.6 |
Conclusion
The present study of depressive illness in retired (elderly) patients is quite useful to physician and psychiatrist, general practitioner, medico-social workers. Majority of the geriatric disease are deeply related to depression. Mental disorders are integral part of geriatric diseases. Hence, while treating; depressive illness must not be ignored. Apart from the medical treatment they must be treated with love and affection. This will lead to speedy recovery of depressive illness in elderly (retired) patients.
