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  • 1.
    Martinsson, Gunilla
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Lindholm, Christina
    Karolinska Institutet.
    Specialist prescribing of psychotropic drugs to older persons in Sweden: a register-based study of 188 024 older persons2012In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 12, no 197Article in journal (Refereed)
    Abstract [en]

    Background

    The situation for older persons with mental disorders other than dementia disorders has scarcely been studied. The older population is increasing worldwide and along with this increase the prevalence of mental disorders will also rise. The treatment of older persons with mental disorders entails complex challenges, with drugs constituting the major medical treatment. Knowledge of geriatric psychiatry is essential for providing older persons with appropriate treatment and care. This study aimed to evaluate the prescription of drugs for mental disorders to older persons (>=65) in Sweden, focused on the medical specialties of the prescribing physicians.

    Methods

    Data concerning drug treatment for older persons from 2006 to 2008 was gathered from the Swedish Prescribed Drug Register. Mental disorders, defined as affective, psychotic and anxiety disorders (ICD-10 F20-42) were evaluated in order to identify associated drugs. Included was a total of 188 024 older individuals, who collectively filled 2 013 079 prescriptions for the treatment of mental disorders. Descriptive analyses were performed, including frequency distribution and 95% CI. The competence of the prescribers was analyzed by subdividing them into five groups: geriatricians, psychiatrists, general practitioners (GPs), other specialists, and physicians without specialist education.

    Results

    GPs represented the main prescribers, whereas geriatricians and psychiatrists rarely prescribed drugs to older persons. Benzodiazepines and tricyclic antidepressants were the most commonly prescribed drugs. Women were prescribed drugs from geriatricians and psychiatrists to a greater extent than men.

    Conclusions

    This study examined the prescription of psychotropic drugs to older persons. Physicians specialized in older persons' disorders and mental health were rarely the prescribers of these drugs. Contrary to clinical guidelines, benzodiazepines and tricyclic antidepressants were commonly prescribed to older persons, emphasizing the need for continuous examination of pharmaceutical treatment for older persons. The results indicate a future need of more specialists in geriatrics and psychiatry.

  • 2.
    Svindseth, Marit F.
    et al.
    Department of Psychiatry, Sunnmore Hospital, 6026 Aalesund, Norway, and National University of Science and Technology, 7440 Trondheim, Norway.
    Nøttestad, Jim Aage
    Department of Forensic Psychiatry, Broset, St. Olav’s Hospital, National University of Science and Technology, 7440 Trondheim, Norway. .
    Wallin, Juliska
    Mälardalen University, School of Sustainable Development of Society and Technology.
    Roaldset, John Olav
    Department of Psychiatry, Sunnmore Hospital, 6026 Aalesund, Norway, and National University of Science and Technology, 7440 Trondheim, Norway. .
    Dahl, Alv A.
    The Cancer Clinic, Rikshospitalet-Radiumhospitalet Medical Center, University of Oslo, Montebello, 0310 Oslo, Norway..
    Narcissism in patience admitted to psychiatric acute wards: its relation to violence, suicidality and other psychopathology2008In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 8, no 13Article in journal (Refereed)
    Abstract [en]

    Background

    The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM).

    Methods

    This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21), The Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM).

    Results

    Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales.

    Conclusion

    Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination.

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