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PubMed1998

[Trends of morbidity and mortality in chronic heart failure in Catalonia].

INTRODUCTION: The epidemiology of chronic heart failure, specifically its morbidity and mortality, is insufficiently known, despite the fact that it has an important economic impact because of the pharmacological treatment and the high hospitalization rate. OBJECTIVE: To analyze the trends of mortality and morbidity of chronic heart failure in Catalonia during the periods 1975-1994 and 1989-1994 respectively. PATIENTS AND METHODS: Specific mortality and morbidity rates (ages 45-65, and older than 65) were calculated for both sexes. Standardised mortality rates were also calculated for mortality rates using the European population as the reference. RESULTS: The trend of mortality of chronic heart failure in the population of 45-65 is stable, the rates being higher for men than for women. The trend in the age group older than 65 shows an important increase from 1983 on, higher in women than in men. Morbidity (hospitalization discharge rates) increases slightly in the population of 45-65 years, especially in men; in the population older than 65 an important increase is observed for both sexes. CONCLUSIONS: Trend of mortality is increasing specifically in women older than 65, while trends of morbidity are clearly increasing for both age groups.

Age Factors↗
PubMed2003

Maternal morbidity after elective repeat caesarean section after two or more previous procedures.

OBJECTIVES: To determine the incidence of maternal morbidity following elective caesarean section in women with a history of at least two previous caesarean sections, and to determine if the incidence of morbidity correlates with the number of previous sections. STUDY DESIGN: We conducted an individual chart review of all women who had an elective caesarean section because of a history of two previous sections from 1990 to 1999. RESULTS: There were 67,097 deliveries of babies weighing 500 g or more. The total number of cases eligible for the study was 250. There were 12 cases (4.8%) of placenta praevia of which four required a transfusion and two a hysterectomy. The incidence of wound infection was 6.3% and urinary tract infection was 11.2%. There were no cases of thromboembolism recorded. CONCLUSIONS: Maternal morbidity with elective repeat caesarean section is low. The major morbidity is associated with placenta praevia. We found no correlation between the incidence of maternal morbidity and the number of previous sections.

Cesarean Section, Repeat↗
PubMed1997

Rectal bleeding after conformal 3D treatment of prostate cancer: time to occurrence, response to treatment and duration of morbidity.

PURPOSE: Rectal bleeding is the most common late sequelae of high-dose 3D conformal treatment (3DCRT) for prostate cancer and may limit attempts to improve local control by dose escalation. The clinical course of this complication is reported including time to onset, response to treatment, duration of morbidity, and multivariate analysis for predictors. METHODS AND MATERIALS: From March 1989 to June 1995, 670 patients with prostate cancer were treated with 3DCRT at Fox Chase Cancer Center. Eighty-nine patients developed Grade 2 or Grade 3 complications due to rectal bleeding and are analyzed. Multivariate analysis results for predictors of Grade 2 and 3 rectal bleeding are reported as well as time to development, response to initial and retreatment, and duration of morbidity. RESULTS: The median time to occurrence is not significantly different (p = 0.09) for Grade 2 (13 months, range 4-41 months) compared to Grade 3 rectal bleeding (18 months, range 4-40 months), while the corresponding median duration of symptoms was significantly different (p < 0.0001) being 1 month (range 1-12) vs. 10 months (1-34) for Grade 2 and Grade 3 bleeding, respectively. For Grade 2 bleeding, medication or coagulation was highly effective as initial or retreatment resolving 66 of 73 patients. For Grade 3 bleeding, three patients responded without medication following blood transfusion only, while with multiple coagulations and medication 12 of 16 patients improved to < or = Grade 1. Multivariate analysis demonstrates that dose is the only significant factor associated with Grade 2 (p = 0.01) or Grade 3 (p = 0.01) rectal bleeding. Of seven nonresponders to treatment for Grade 2 bleeding, three have died of intercurrent disease at 10, 19, and 26 months, while four are alive with continuing Grade 2 bleeding at 12, 14, 15, and 30 months after onset. The four nonresponders to treatment for Grade 3 bleeding continue to bleed 1, 9, 32, and 35 months after the third coagulation despite continuing care. CONCLUSIONS: Chronic rectal bleeding is a sequelae of high-dose conformal treatment of prostate cancer. Grade 2 morbidity responds to medication or limited coagulation (< or = 2) in 90% of patients. Grade 3 morbidity responds to medication and multiple coagulations (> or = 3) in 75% of patients. The chronicity of Grade 3 morbidity is illustrated by a 10-month median duration for response to treatment, with a range of response extending to 34 months. Nonresponders to treatment have continued to bleed up to 35 months after the third coagulation. Appropriate shielding of the rectal mucosa limiting dose to < 72 Gy is required to avoid a high incidence of these complications, as dose is the only significant variable associated with rectal bleeding.

Aged↗
PubMed1999

Perioperative morbidity and mortality after transmyocardial laser revascularization: incidence and risk factors for adverse events.

OBJECTIVES: The purpose of this study was to describe the incidence and spectrum of perioperative cardiac and noncardiac morbidity and mortality after transmyocardial laser revascularization (TMR) and to identify predictors of these adverse clinical events. BACKGROUND: Clinical studies have demonstrated the efficacy of TMR for relieving angina pectoris, although no study to date has specifically addressed the associated perioperative morbidity and mortality. METHODS: Between October 1995 and August 1997, 34 consecutive patients with end-stage coronary artery disease (CAD) underwent isolated TMR. The majority of patients (94%) had class III or IV angina pectoris, and two patients (6%) had unstable symptoms preoperatively. Patient records were reviewed for fatal and nonfatal adverse cardiac and noncardiac events. RESULTS: Perioperative death occurred in two patients (5.9%) due to cardiogenic shock complicating acute myocardial infarction. Perioperative cardiac morbidity occurred in 16 patients (47.1%); noncardiac morbidity was seen in 12 patients (35.3%). Preoperative unstable angina was the only variable predictive of perioperative death (p = 0.005). Cardiac (p = 0.005) and noncardiac (p < 0.001) morbidity rates were significantly higher for the initial 15 patients undergoing the procedure. Other predictors of perioperative complications included lack of postoperative treatment with a furosemide infusion (p < or = 0.04) and preoperative unstable angina (p = 0.05). CONCLUSIONS: Perioperative mortality in patients undergoing isolated TMR is low. Transmyocardial laser revascularization patients are at higher risk for adverse perioperative cardiac and noncardiac events, likely reflecting the lack of immediate benefit from the procedure in the setting of severe CAD. These patients merit vigilant surveillance for adverse events and aggressive medical management in the perioperative period.

Adult↗
PubMed2000

Co-morbidity data in outcomes research: are clinical data derived from administrative databases a reliable alternative to chart review?

Evaluation of co-morbidity data is essential in health outcomes research. Co-morbidity data derived from administrative databases has been criticized for lacking the accuracy required for clinical research. We compared co-morbidity data derived from a Canadian provincial hospitalization database with chart review in 817 adults treated with a percutaneous coronary intervention at a single tertiary care hospital between 1994 and 1995. While the administrative database tended to under-estimate the prevalence of some co-morbid conditions, the agreement between chart review and administrative data was good to very good for most conditions. Asymptomatic conditions were noted to have lower levels of agreement. Multivariate risk models for all-cause mortality constructed from both data sources were almost identical, suggesting minimal misclassification. The results indicate that clinical data abstracted from most Canadian hospitalization databases can provide reliable information regarding baseline co-morbid conditions believed to influence survival in a population undergoing percutaneous coronary interventions.

Adult↗
PubMed1999

Associations between an asthma morbidity index and ideas of fright and bother in a community population.

There is a need for simple asthma outcome measures for primary care which are not only valid in terms of their relationship with lung function but also in terms of pragmatic psychological constructs. This study assesses the usefulness of adding items on the degree of 'bother' and 'fright' caused by the condition to a previously validated simple asthma morbidity index. A postal questionnaire survey comprising a simple asthma morbidity index and questions on 'fright' and 'bother' was conducted in one general practice in the north-east of England. Responses were obtained from 570 individuals. Of these, 184 (32%) reported low, 133 (23%) medium and 253 (44%) high morbidity. Twenty-nine per cent of respondents had felt frightened by their asthma in the previous 4 weeks. Both the 'fright' and 'bother' items were significantly associated with the morbidity index. The addition of 'bother' and/or 'fright' questions may improve both the content, construct and predictive validity of the morbidity index, but this needs to be established prospectively.

Anxiety↗
PubMed2001

Morbidity after surgery for non-small cell lung carcinoma is not related to neoadjuvant chemotherapy.

OBJECTIVES: To compare postoperative morbidity and mortality rates in two groups of operated non-small cell lung carcinoma patients (NSCLC) with or without induction chemotherapy. METHODS: This is a case-control study on 42 cases and 42 controls. Cases (Group A) underwent induction chemotherapy. Chemotherapy indications and regimens were variable. Control cases (Group B) were randomly selected among 494 NSCLC comparable patients operated on in the same period of time. The selection criteria for operation were the same in both groups. Dependent outcomes were operative death and complications. Independent selected variables were: age, co-morbidity, predicted postoperative FEV1% (1 s forced expiratory volume in percentage), type of surgery and clinical and pathological staging. All postoperative events and independent variables were prospectively registered. Chi-square and risk calculations on contingence tables and one-way ANOVA have been tested. RESULTS: Both series are comparable in demographics, preoperative variables and type of surgery. No mortality has been registered. In Group A, the overall morbidity was 26.2% (11 out of 42 cases), and in Group B, this was 42.9% (18 out of 42 cases; P=0.084). Morbidity was not related to the type of surgery (pneumonectomy vs. other; P=0.205 in Group A and P=0.08 in Group B). Pathological staging did not influence the postoperative outcome, either in Group A (P=0.72; odds ratio, 1.515; 95% confidence interval (CI), 0.375-6.122) or Group B (P=0.299; odds ratio, 0.4; 95% CI, 0.089-1.797). CONCLUSIONS: Induction chemotherapy in NSCLC has no influence on postoperative morbidity.

Adult↗
PubMed1998

Perinatal mortality and morbidity rates among singleton, twin, and triplet gestations.

Objective: To determine rates of perinatal mortality and morbidity from 24 to 43 weeks gestation among singletons, twins, and triplets.Methods: Successfully linked data from 1992 Californian maternal and infant discharge records as well as birth and death certificates from acute care civilian hospitals were examined for perinatal mortality and morbidity. Perinatal mortality was defined as the sum of all stillbirths and neonatal deaths. Deliveries from 24 to 43 weeks gestation among singleton, twin, and triplet pregnancies were collected as separate data sets. Perinatal mortality was identified using birth certificate death indicators excluding deaths caused by congenital anomalies. Neonatal deaths were identified from death indicators found in the death certificates. For the purpose of this study, perinatal morbidities were identified by ICD-9 codes and limited to respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC). Perinatal mortality and morbidity rates were expressed as a percent of live births stratified by gestational age. Perinatal mortality data were expressed in log scale and perinatal morbidity rates were statistically compared.Results: There were 571,390 total births in California of which 527,677 (92%) were singleton, 12,535 (2%) were twin, and 367 (0.06%) were triplet gestations. Across gestation, the rate of RDS between triplets and twins was comparable (6.6% vs 6.8%). However, the rates of IVH and NEC were significantly greater in triplets than in twins (20% vs 8%, P <.0001, and 25% vs 9%, P <.0001, respectively). The perinatal mortality rates are shown below.Conclusions: Perinatal mortality rates were comparable among singleton, twin, and triplet gestations delivered between 24 and 30 weeks gestation. Unlike singletons and twins, the triplet perinatal mortality rate did not fall between 31 and 36 weeks gestation and remained at 2.6%. Twin perinatal mortality rate was equivalent to singletons until 36 weeks gestation. IVH and NEC were significantly greater among triplets regardless of gestational age. These data suggest that antepartum fetal surveillance of triplet pregnancies should start as early as 30 weeks gestation while testing for twin pregnancies can begin at 36 weeks gestation.

Journal Article↗
PubMed2004

[Respiratory morbidity after hospital discharge in premature infants born at < or = 32 weeks gestation with bronchopulmonary dysplasia].

BACKGROUND: Bronchopulmonary dysplasia (BPD) is the most frequent cause of respiratory morbidity in the first 2 years of life among preterm infants who survive the first 28 days. OBJECTIVES: To evaluate respiratory morbidity in the first 2 years of life in a group of preterm infants born at (32 weeks' gestation with BPD (oxygen requirement at 36 weeks' postconceptional age) by comparing it with that in preterm infants born at (32 weeks without BPD and with a control group of full term infants without neonatal morbidity. To determine whether respiratory morbidity in children with BPD decreases after the age of 2 years. PATIENTS AND METHOD: Group I: preterm children with BPD (n = 29). Group II: preterm children without BPD (n = 29). Group III: children with appropriate gestational age and weight (n = 32). A cross-sectional, descriptive study of the three groups was performed over a 2-year period. In 17 children in group 1, the study was prolonged to the age of 4 years. We analyzed wheezing on at least two occasions, use of inhaled bronchodilators, use of inhaled glucocorticosteroids for more than 6 months, and hospitalization for respiratory illness. The chi-square test and Fischer's exact test were performed. RESULTS: At least one episode of wheezing occurred in 25 children (86.2%) in group I compared with 12 children (41.4%) in group II and 6 (18.8%) in group III. Nineteen children (65.5%) in group I and none in the remaining two groups received treatment with inhaled glucocorticosteroids for more than 6 months (p < 0.001). Inhaled bronchodilators were used by 25 children (86.2%) in group I compared with 12 (41.4%) in group II and 6 (18.8%) in the control group (p < 0.001). Twelve children (41.3%) in group I were hospitalized for respiratory illness compared with 8 (27.6%) in group II. There were no admissions among the control group. None of the children with BPD who received prophylaxis with palivizumab contracted respiratory syncytial virus infection. Seventeen children with BPD were evaluated until the age of 4 years. Episodes of wheezing decreased from 88.2% in the first year to 41 % between the third and fourth years (p < 0.001). Treatment with inhaled glucocorticosteroids for more than 6 months was given to 88.2% in the first year, 41.2 % between the first and second year and to 0 % after the second year (p < 0.001). Hospital admissions for respiratory illness decreased from 52.9% in the first year to 17.6% in the second year. None of the children were hospitalized after the age of 2 years (p < 0.001). CONCLUSIONS: During the first 2 years of life, children with BPD showed a greater number of admissions and episodes of wheezing and a greater need for medical treatment. Respiratory morbidity improved with age, 40% showed recurrent wheezing episodes at the age of 4 years.

Bronchopulmonary Dysplasia↗
PubMed1992

Comorbidity of substance abuse and schizophrenia: the role of pre-morbid adjustment.

Co-morbid substance use and abuse is common in schizophrenic patients, and the role of substance abuse in initiating and maintaining psychosis has important definitional and aetiological implications. We investigated the issue in a cohort of 131 schizophrenic patients. We found non-users (N = 67) were similar to pathological users (N = 64) in current symptomatology and clinical history. The pathological users did, however, have better pre-morbid adjustment levels. Only alcohol use and to some extent cannabis use contributed to this effect; use of stimulants or hallucinogens did not. These results indicate the importance of evaluating the various types of substance used when attempting to explore the significance of co-morbidity. The results also suggest that co-morbidity of substance abuse and schizophrenia may be explained by a common factor antecedent to both: better pre-morbid adjustment. A two-stage model is proposed to explain these findings: increased sociability increases exposure to opportunities of substance use in a subset of patients; subsequent onset of psychotic illness accelerates the use to a pathological level as the individual attempts to cope with the stress of the developing mental illness.

Adaptation, Psychological↗
PubMed1992

Why people with probable minor psychiatric morbidity consult a doctor.

This epidemiological investigation examines factors determining medical consultation in people with probable minor psychiatric morbidity. About 54% of people with probable minor psychiatric morbidity and about 23% of the (numerically much greater) remainder with lower probability of psychiatric morbidity consulted a doctor, usually a primary care physician, in the two weeks prior to a research interview. Medical consultation rates were higher in females than in males. The dominant finding was that in people with probable minor psychiatric morbidity physical illness was strongly associated with medical consultation. Almost 89% of males and 97% of females with probable minor psychiatric morbidity and physical illness consulted a doctor in the two weeks prior to interview. Logistic regression modelling was used to investigate the joint effects on medical consultation of physical illness and six socio-demographic variables, and physical illness emerged as the major single determinant of medical consultation in women and, in men, it exerted its effect through an interaction with lower educational level.

Adolescent↗
PubMed1996

Adrenal secretion and major depression in 8- to 16-year-olds, II. Influence of co-morbidity at presentation.

The association between high evening cortisol and low morning DHEA and the pattern of co-morbid diagnoses in 82 cases of major depressive disorder in 8- to 16-year-olds has been analysed. There was a significant association between the presence of high evening cortisol and co-morbid dysthymia. This was independent of age or sex. No positive association was found between the presence of low morning DHEA and any co-morbid diagnosis. However, co-morbid panic or phobic disorder was significantly associated with the absence of this endocrine abnormality. These findings suggest that specific endocrine disturbances may be associated with different patterns of co-morbidity during an episode of major depression in this age group.

Adolescent↗
PubMed1995

Hysterectomy and psychiatric disorder: are the levels of psychiatric morbidity falling?

This paper compares the findings of three studies carried out at intervals over the years 1975-1990. The three studies were concerned with different issues, but each study examined psychiatric morbidity among women undergoing hysterectomy for menorrhagia of benign origin. In all three studies levels of psychiatric morbidity were measured before the operation and 6 months after the operation. Psychiatric morbidity was measured with the Present State Examination (PSE) (Wing et al. 1974), and with established self-report questionnaires. Levels of psychiatric morbidity fell significantly across the three studies. In Study 1, the proportions of psychiatric cases were 58% before hysterectomy and 26% after; in Study 2, 28% before and 7% after; and in Study 3, 9% before and 4% after. The decline in psychiatric morbidity was not associated with demographic and social characteristics, previous psychiatric history, family psychiatric history, the nature of the women's menstrual complaints, or the women's understanding and expectations of the operation. In Study 3 anti-menorrhagic drugs were prescribed twice as frequently as in the two previous studies; while the prescribing of psychotropic medication was significantly higher in Study 1 than in Study 2 or Study 3. The implications of these findings are discussed.

Adaptation, Psychological↗
PubMed2003

Family study of co-morbidity between major depressive disorder and anxiety disorders.

BACKGROUND: Numerous studies have documented high rates of co-morbidity between major depressive disorder (MDD) and the anxiety disorders (ANX). However, the reason for this is unclear. Family studies provide one potentially useful approach for addressing this issue. METHOD: We explored six explanations of the co-morbidity between MDD and ANX using a family study of a large community sample of young adults and their first-degree relatives. Participants included 112 probands with a lifetime history of both MDD and one or more ANX, 290 probands with a history of MDD but no ANX, 43 probands with a history of one or more ANX but no MDD. 352 probands with no lifetime history of either MDD or ANX, and the probands' 2608 first-degree relatives. Probands were assessed using semi-structured diagnostic interviews on two occasions in adolescence and a third time at age 24. Diagnostic data on relatives were collected using both direct and family history interviews. RESULTS: Compared with controls, MDD aggregated in the families of probands with MDD, whether or not they had co-morbid ANX; ANX aggregated in the families of probands with ANX, regardless of whether they had co-morbid MDD; and co-morbid MDD/ANX aggregated only in the families of probands with both MDD and ANX. The relatives of probands with ANX alone had a significantly higher rate of ANX than the relatives of probands with MDD alone, although none of the other comparisons between the depressed and anxious groups were significant. CONCLUSIONS: This pattern of findings is largely, although not completely, consistent with the view that MDD and ANX are transmitted independently within families, and suggests that the comorbidity between MDD and ANX is caused by non-familial aetiological factors.

Adolescent↗
PubMed2006

Pre-morbid IQ and response to routine outcome assessment.

BACKGROUND: Routine use of standardized outcome measures within adult mental health services is compulsory in many countries, but not common in clinical practice. As well as political and professional factors, one reason may be that there is little empirical evidence of benefit for patients. It is therefore important to identify predictors of response. Pre-morbid intellectual functioning has predicted response to other interventions. This paper tests the hypothesis that pre-morbid IQ impacts on the effectiveness of routine assessment and feedback of outcome measures. METHOD: The Feedback of Outcomes to Users and Staff (FOCUS) single-blind randomized controlled trial (RCT) investigated routine completion and feedback of outcome measures for 160 (101 intervention, 59 control) adult mental health service patients in Croydon, South London (International Standard RCT Number 16971059). RESULTS: Patients in the top quarter (pre-morbid IQ>110) differentially improved in patient-rated unmet need (adjusted difference 3.4, 95% CI 0.8 to 5.9, p=0.012) and in the top half (pre-morbid IQ>99) in quality of life (adjusted difference -0.6, 95% CI -1.1 to -0.1, p=0.02). The top quarter result remained when controlling for the influence of baseline (p=0.004) and baseline plus follow-up variables (p=0.047). CONCLUSIONS: Feedback of routine outcome measures may improve outcome for patients with higher pre-morbid IQ. There is a need to understand more how routine outcome information is used by staff and patients to inform care. If the goal of routine use of outcome measures is to benefit patients directly, then targeted policies are required.

Adolescent↗
PubMed2006

Contrasting models of genetic co-morbidity for cannabis and other illicit drugs in adult Australian twins.

BACKGROUND: The use of cannabis and other illicit drugs (OIDs) and their co-morbid misuse are frequently reported in the literature. Correlated vulnerabilities and causal or gateway influences have been implicated in this association. We investigated the source of this co-morbidity between cannabis use (experimentation, early and repeated use, and problems) and OID experimentation and problems using genetic models proposed by Neale and Kendler (American Journal of Human Genetics 1995, 57, 935-953). METHOD: In a sample of 4152 same-sex male and female adult Australian twin individuals, we fit 13 genetically informative models of co-morbidity to data on experimentation, early use, repeated use of cannabis and co-morbid OID experimentation, and to abuse/dependence (A/D) problems with cannabis and OIDs. RESULTS: Model-fitting results suggest that common genetic, shared and unique environmental factors are responsible for the association between cannabis experimentation, early use, repeated use and A/D problems and OID experimentation or problems. The liability causation model, which is a reduced form of the correlated vulnerabilities model, also fit very well. In women, we found evidence for high-risk cannabis experimenters and repeated users to be at increased risk for OID experimentation, despite being below the risk threshold on the liability distribution for OID experimentation (extreme multiformity). CONCLUSIONS: Co-morbid cannabis and OID use and misuse are due partly to a common predisposition to substance use disorders. Putative causal effects could not be ruled out. These models warrant further research, so that features of the correlated vulnerabilities model and the gateway models can be studied jointly in a single series of adaptive nested models.

Adolescent↗
PubMed1997

The National Psychiatric Morbidity surveys of Great Britain--strategy and methods.

BACKGROUND: This paper describes the rationale and methodology of the first national psychiatric morbidity surveys to be carried out in Great Britain. The objectives of the surveys were to estimate the prevalence of psychiatric morbidity among adults aged 16-64 living in Great Britain; to identify the nature and extent of social disabilities associated with psychiatric morbidity; to describe the use of health and social services by people with psychiatric morbidity and to investigate the association between mental illness and potential environmental risk factors in a household sample. METHODS: Four separate surveys were carried out in order to meet the objectives; a private household sample (N = 10108), a sample of institutions caring for the mentally ill (N = 1191), a sample of homeless people (N = 1166), and a supplementary sample of patients with psychosis living in private households (N = 350). A two-stage assessment procedure was used, in which all subjects were given the Revised Clinical Interview Schedule (CIS-R) administered by lay interviewers to assess neurotic symptoms and disorders and a psychosis screen, including the Psychosis Screening Questionnaire. Those who were positive on the psychosis screen were then interviewed by psychiatrists using the SCAN (incorporating the tenth edition of the Present State Examination). CONCLUSIONS: Large scale national surveys such as this augment the inadequate data on psychiatric morbidity that are routinely available and are, therefore, an important source of information upon which to base policy and generate aetiological hypotheses. These surveys provide a possible model for similar surveys in other countries.

Adolescent↗
PubMed2000

Psychological morbidity among informal caregivers of older people: a 2-year follow-up study.

BACKGROUND: It has long been assumed that mental frailty in older care-recipients results in a deterioration in family caregivers' psychological well-being. This hypothesis has not been tested in longitudinal studies. Research about the impact on families of supporting older people in institutions is limited. The present study examined psychological morbidity in informal caregivers of frail older people at home and in institutions. Caregivers were followed up over 2 years. Predictors of psychological morbidity in caregivers and factors related to deterioration in their well-being over time were identified. METHODS: Two-year panel survey of informal caregivers of older care-recipients, using semi-structured interview schedules and the 30-item GHQ. Care-recipients were those defined as physically or mentally frail after screening a stratified random sample of people aged > or = 65. Respondents were 276 caregivers of older people living at home at baseline and 47 visitors of those in long-term care at baseline. RESULTS: There were no differences in GHQ scores between caregivers at home and visitors, and no changes in GHQ score over time. The strongest predictors of psychological morbidity at follow-up, and of change in GHQ scores over time, were baseline GHQ score and indicators of subjective well-being. Characteristics of care-recipients, including frailty type (mental or physical), were not significantly associated with changes in caregivers' psychological morbidity. CONCLUSIONS: Mental frailty in care-recipients was not associated with deterioration over time in caregivers' psychological well-being. Caregiver characteristics were stronger than those of care-recipients in predicting psychological morbidity at follow-up and in predicting deteriorating well-being over time.

Aged↗