Angeles University Foundation Angeles City, Philippines A.Y. 2022-2023 EVIDENCED-BASED JOURNAL: Acute Psychiatric Unit Submitted by: Missy Ann Montillon Submitted to: Ms. Cherry Sangcap, RN, MsN A. TITLE 1. Research Title: Prevalence and factors associated with anxiety and depression in older adults: Gender differences in psychosocial indicators 2. Authors: Emma Curran Michael Rosato Finola Ferry Gerard Leavey 3. Date of Acceptance for Publication: 6 February 2020 4. Date of Submission for the Publication: 19 December 2019 5. Name of the Journal: Journal of Affective Disorders 6. Journal Details: Volume 26, Pages 114-122, DOI: https://doi.org/10.1016/j.jad.2020.02.018 B. INTRODUCTION: Main Problem Tackled in the Journal, Background of the Problem, Objectives of the Research, and Significance of the Research As the population ages, the amount of time spent in excellent health provides significant personal, societal, and economic advantages. Whereas anxiety and depression may both be adaptive physiological strategies for survival wherein pathological symptoms can develop when linked pathways are disrupted by trauma or persistent stress. Comorbid anxiety and depression are common in old age psychiatry with approximately 90% of patients with anxiety also reported experiencing symptoms of depression which may lead to lower life expectancy, health issues, and deaths. It's crucial to distinguish between pathological and adaptive symptoms in old age as some symptoms may be mistaken for temporary adaptations to aging. Therefore, the danger of both physical and mental disorders increases if untreated. Older adults may not achieve adequate assistance or care without a proper diagnosis, which can also reveal undetected subthreshold symptoms, excessive levels of adaptive anxiety, or dual diagnoses. In contrast to adaptive emotions or isolated conditions, comorbid pathological disorders are more treatment-resistant and have a greater suicide rate. They may also cause more severe psychological, physical, and social problems. Thus, it is clinically important for the aging population to understand how these illnesses occur and the factors that contribute to them. The need for psychosocial therapies and the administration of pharmacological treatments can both be considerably improved by taking into consideration symptom profiles and connections with a variety of social and medical variables in elderly patients. Nonetheless, this study aims to investigate: the prevalence of anxiety and depression among older persons who live in communities and to evaluate the socio demographic traits connected to symptom profiles and connections to a variety of psychological and clinical indicators. C. METHODOLOGY: Research subjects/respondents/participants, Research design, Appropriateness of the design, Method for data collection, and Data Analysis used Using statistics from The Irish Longitudinal Study on Aging, a cross sectional analysis was conducted. 8175 adults who were fifty years of age or older and their wives or partners made up the representative sample community based sample. The latent class analysis identified gender-specific trait patterns for anxiety and depression. Using logistic regression, the connections between socio-demographic and social characteristics were examined as correlates of latent classes and health indicators. D. RESULT: Results of the study (brief and concise as possible) Self-reported anxiety and depression are divided into four categories: "low," "comorbidity," "anxiety and subthreshold depression," and "anxiety only." In men, 8% had comorbid conditions, 26% had subthreshold conditions, and 26% had anxiety alone. With females, 12% had comorbid conditions, 27% were below the threshold, and 29% had anxiety alone. While symptom expression may be correlated to age-related stress, our data demonstrate distinct gradations of symptoms linked to a variety of psychological and clinical indicators. E. DISCUSSION: Relevance of the Evidence-based journal to nursing practice, education, and research journal (Identify at least 1 strength and 1 weakness of the journal These data show different age and gender variations. First, it appears that all disorder symptoms are most strongly linked to relatively younger persons (ages 50 to 59), presumably due to difficulties in the transitional life stage around retirement. The results support the claim that retirement age may be a risk factor for mental illness and loneliness. Second, although there is a clear correlation between loneliness and depression (co-morbid or subthreshold), anxiety does not seem to influence those with loneliness, possibly indicating that anxiety has less of an impact on social relationships than one might assume. Additionally, those with co-morbid depression and anxiety have the highest associations for both male and female loneliness, indicating a gradient across the illness subgroups. Third, we identified that, unlike their male partners, women with anxiety manage to maintain social networks that may be preventive against loneliness and depression, even though low family income and relationship stress were related to mental ill health. Females may have developed larger, more protective networks over the course of their lives than men, who might be too reliant on smaller family relationships and less safeguarded when these ties break down. Furthermore, female adolescents (ages 14 to 25) had twice as much depression as male adolescents, and this ratio decreases gradually as people get older. However, there is a decline in depression rates for both sexes with a trend approaching convergence after 65 years. Men and women have different predictors of psychological problems, but they also differ from one another in a number of ways. Therefore, while marriage is typically beneficial, it can also cause stress for some people and is felt differently by men and women. Additionally, when people become older, their roles and status may alter, which could have different sociocultural and psychological effects on men and women. Therefore, the end of childrearing and the start of retirement may have different effects on men and women. Compared to men, women seem to have built stronger, non-work-related networks after retirement. As a result, it is possible to hypothesize that unique loci within the symptoms of depression and anxiety may be associated with sociocultural distinctions related to role and position. Weakness of the Journal: The study does not provide a solution to the question of whether anxiety precedes a depressed mood or not, serving as a chronic stressor that initiates depression. However, it does raise questions about social isolation amongst elderly individuals who suffer from anxiety and depression and its implications. To decide whether people need a more complete assessment of their depressive or anxious symptoms, the CES-D and HADS-A can be used as preliminary screening instruments. However, it must be understood that they are not standalone diagnostic tools. Every participant whose scores exceeded the established cutoff points should go through additional diagnostic testing in a clinical setting. Additional diagnostic tests are particularly necessary to validate a diagnosis and to differentiate between anxiety and depressive disorders. Strength of the Journal: Given these constraints, data from the CES-D and HADS-A are sufficient for profiling this population and identifying risk factors for worse mental illness, which is useful for developing specific community-level interventions for this population, in response to stressors, anxiety frequently precedes depression. By recognizing persons with different levels of depression, health professionals can advocate for early community intervention, which may lessen the burden in clinical settings. CONCLUSION AND RECOMMENDATION: Applicability of the journal findings to Nursing Practice, Education and Research This research finds a significant frequency of mental illness among the aging population, emphasizing the significance of accurate diagnosis and therapy as a significant concern. The most prevalent mental illnesses in primary care are depression and anxiety, which take up a large portion of health providers' responsibilities. Therefore, a more detailed understanding of risk variables is required to aid in early diagnosis. People who are older are more likely to be ill or disabled and to seek primary care more frequently. Therefore, general medical visits among the elderly population offer a good chance to evaluate for mental illness and give prompt care. The results demonstrate that patterns of mental illness are influenced by demographic and contextual factors; these implications should be considered when designing the best possible care delivery. Furthermore, the improvement of older people's mental health care will be a concern for nurses globally and locally as the world's population ages. Providing excellent mental health nursing care should be a major and continuing concern. Administrators, legislators, organized groups, researchers, and clinical nurses would all devote more attention to the importance of high-quality care as the number of elderly persons in our society rises. Clinical considerations include the necessity for nurses to be conscious of the behaviors they consider to be signs of compassion which makes them more motivated to implement and reinforce compassionate behaviors and be adaptable in high-stress contexts with shorter hospital stays, higher levels of acuity, and lower nurse-to-patient ratios. Furthermore, nurses must be equipped to make a substantial contribution to the early evaluation and treatment of any mental health issues that older people may suffer. This entails taking a thorough history and using documentation and screening tools, behavioral analysis systems, etc. Consequently, nurses would be in a unique position to put non-pharmacological measures into action and analyze them in order to decrease the beginning of unnecessary psychiatric medication.
