Brief Intervention for Substance Abuse among Rural Elderly

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Ami Wilkerson
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1 Brief Intervention for Substance Abuse among Rural Elderly Shivanand Kattimani 1, Sonali Sakar, K C Premarajan, Gautam Roy Department of Preventive and Social Medicine & 1 Department of Psychiatry, Dhanvantari Nagar, JIPMER, Puducherry, India Objectives This study describes the effect of single session specialized counseling (Brief Intervention) for rural elderly with substance abuse. It is prospective study, conducted in the rural area of Puducherry district between 2012 and All eligible available elderly for substance abuse were screened using standard tool ASSIST v 3.0 (The Alcohol, Smoking and Substance Involvement Screening Test). Those with high risk were referred to specialized de-addiction service centers and those with moderate risk were taken for brief intervention. After one year post-intervention assessment was done using the same screening tool. We analyzed for difference in risk categories for particular substance among those who received brief intervention. At baseline we recruited 263 elderly people. 242 completed the post-intervention assessment at the end of one year. Data was analyzed for the 242 elderly who completed the study. In the preintervention period 94 belonged moderate risk category for tobacco use and in the post-intervention period their number reduced to 46 (nearly 50% reduction), the rest moving to lower risk/no risk categories. In the pre-intervention survey there were 41 moderate risk alcohol users. At postintervention survey only 9 were found to have moderate risk alcohol uses i.e. a nearly 80% reduction. Conclusion Brief Intervention is useful in the elderly moderate substance users. Key words: substance use disorder, elderly, counseling, de-addiction, alcohol, tobacco, community

It is prospective study, conducted in the rural area of Puducherry district between 2012 and 2013. All eligible available elderly for substance abuse were screened using standard tool ASSIST v 3.

2 Dementia Care and Caregiver Mental Health A Cross Sectional Study Authors: Cyriac George, Shijin A Ummar, Shaji K S Government Medical College, Trichur, India Aims and objectives To assess caregiver burden, prevalence and factors associated with depressive symptoms in primary caregivers of community resident older people with dementia. Methodology We identified people with dementia with the help of health workers employed by a local nongovernmental organization and evaluated them. A clinician trained in psychiatry interviewed primary caregivers to assess caregiver burden and mental health. We identified 44 cases of dementia in the community. More than a quarter (27.3%) of primary caregivers reported significant burden. Depressive symptoms were common and 9 (20.5%) of the caregivers met criteria for an episode of depression as per ICD-10. Caregiver burden was associated with diagnosis of depression. Conclusions Depression is common in dementia caregivers. There is a need for community based interventions to support caregivers of people with dementia.

Methodology We identified people with dementia with the help of health workers employed by a local nongovernmental organization and evaluated them.

3 Dementia in Indian Cinema: A Narrative Review Badr Ratnakaran, Sethulakshmi S Anil Holy Cross Hospital and Mental Health Centre Koovapally, Kerala, India Background Indian cinema is known for portraying social, cultural, and political issues as well as issues in mental health. Objectives To review the portrayal of dementia in Indian cinema. Films were identified after discussion with various experts in person, telephone and correspondence. Web databases were also checked to identify the films. Eight films portraying balanced and unbalanced versions of dementia and its related issues have been identified. Caregiver issues have been discussed in the films. However treatment and other interventions have not been discussed. Conclusion It can be concluded that these films can be used as a resource for movie clubs as part of the teaching curriculum during postgraduate and undergraduate training. They can be an excellent medium to understand cultural issues related to dementia in the community. Keywords: Dementia, Indian cinema, Movie clubs

Films were identified after discussion with various experts in person, telephone and email correspondence. Web databases were also checked to identify the films.

4 Diagnosis of Dementia using rule based Bayesian approach: Findings from Mysore studies of Natal Effect on Ageing and Health (MYNAH) Krishna M 1, BhagyashreeS 2, DanivasV 3, Ramya M C 1, S C Karat 4, Seshadri H S 5, K Kumaran 6, C H D Fall 6, Prince M 7 1 CSI Holdsworth Memorial Hospital, Mysore, India 2 Department of Electronics and Communication, ATME College 3 Department of Psychiatry, Mysore Medical College and Research Institute, Mysore, India 4 CSI Holdsworth Memorial Hospital, Mysore, India 5 Department of Electronics and Communication, PES College of Engineering, Mandya, Karnataka, India 6 MRC Lifecourse Epidemiology Unit, University of Southampton, UK 7 Institute of Psychiatry, King s College, London,UK 10/66 Dementia Research Group developed and validated a battery of cognitive tests for use in LMICs. We examined diagnostic properties of the cognitive domains of this battery in 466 men and women aged years from the MYNAH study. Diagnosis of dementia was derived by application of the rule based Jrip classification with a diagnostic cutoff set at normative mean for urban Indians and compared with clinician diagnosis of dementia. Sensitivity, specificity and kappa for diagnosing dementia for CSIDCOGSCRE a global cognitive functions core were 72.22, and 0.69; for Verbal Fluency were 66.66, and 0.47; Word List Recall were 100, and 0.69 and for any two of the three cognitive domains were 100, and 0.69 respectively. Positive and negative predictive values for the latter were 0.54 and 1 respectively. We have derived algorithms for developing of an embedded system for making diagnosis of dementia in resource poor settings.

Medical College and Research Institute, Mysore, India 4 CSI Holdsworth Memorial Hospital, Mysore, India 5 Department of Electronics and Communication, PES College of Engineering, Mandya, Karnataka,

5 Treatment Gap in Late Life Depression Shaji K S, Anisha Nakulan, Rejani P P, Sebind K, Sumesh T P Government Medical College, Trichur Aims and Objectives To estimate the treatment gap for depression in community resident older people. 908 community resident older people of a village in Kerala, India were assessed by clinicians trained in psychiatry. Those who met the ICD-10 criteria for a depressive episode and needing antidepressant drugs were identified. The information regarding history of treatment for current episode of depression was collected. 106 older people needed treatment for depression. Only 9 of them were getting treatment for depression. The treatment gap was 91.5%. Conclusions Depression is a common mental health problem in late life and the treatment gap is large in community settings.

Those who met the ICD-10 criteria for a depressive episode and needing antidepressant drugs were identified.

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