Aims and Objectives: To study loneliness, depression and coping mechanism and the relationship between these factors in depressed and non-depressed elderly. Materials and Methods: Cross sectional study was done on 46 depressed and 48 non-depressed elderly were assessed clinically and using Geriatric Depression Scale-Short form [GDS-SF], loneliness scale, and brief cope scale. Statistical analysis was done using SPSS 20 software. Result: Mean GDS scores, mean loneliness (emotional and social) scores of depressed patients were higher than that of non- depressed, and this difference was found to be statistically significant [GDS: t = 14.33, p<0.001, loneliness Score: t = 7.23, p<0.001]. Self-distraction (mal-adaptive-passive) was the most commonly used coping mechanism in depressed group, while in the non-depressed group active coping (adaptive) was most common coping mechanism. Loneliness (emotional as well as social subscale) was a significant predictor of depression in both depressed and non-depressed group (Beta = .714, p<0.001) and (Beta = .629, p<0.001) and predicted 51% and 39% variance in depression respectively. Loneliness appeared as a distinct factor which seems to have a temporal and synergistic relationship with depression. Use of more adaptive coping mechanisms is associated with decrease in loneliness and depression while use of maladaptive coping mechanism is associated with decreased depression and loneliness in elderly. Conclusion: Loneliness is an important distinct factor in predicting depression in elderly. Coping mechanisms used, also affects loneliness and depression significantly.

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Aims and Objectives: To study and compare the perception of old age and self in elderly women living in community and in old age homes. Materials and Methods: By using a cross sectional study design 60 elderly females (30 each from community and old age homes) were assessed using a semi-structured proforma and an interview questionnaire. Data was qualitatively analysed and frequency computation was done. Results: The elderly women living in community had more of an attitude of 'acceptance' towards old age and 'generativity' was a part of ageing for them. They were found to be more satisfied with life and had better emotional support, whereas elderly in old age home perceived better instrumental support. Conclusion: Both community living and living in an old age home, have certain positive aspects. From a perspective of future policies and outreach services, it would be interesting to note the same and use best of both the worlds to provide the best for the elder in either setting.

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Aims and Objectives: To determine the relationship between depression, perceived and received social support. Materials and methods: Forty elderly (age >60 yrs) subjects were assessed for depression and social support using Berlin Social Support Scale. Result: Significant negative correlation was seen between perceived social support and depression (r = −.413; P < 0.01). There was no significant correlation between depression and received social support. Conclusion: Perception of social support in elderly is affected by depression. Adequate treatment of depression which improves negative cognition would help in the perception of social support for elderly subjects who are depressed and aid in recovery.

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Aims and Objectives: This study aimed to assess the suicidal ideations, hopelessness and impulsivity in depressed and non-depressed elderly and to study the relationship of suicidal ideations with hopelessness and impulsivity in them. Materials and Methods: This cross sectional study was done on 60 elderly patients (30 cases and 30 controls) above the age of 60 years. The scales used were Geriatric Suicide Ideation Scale, Beck Hopelessness Scale, Barrat's Impulsiveness Scale, Geriatric Depression Scale. Results: Mean Geriatric Suicide Ideations Scale scores, mean Beck Hopelessness Scale scores and mean Barrat's Impulsiveness Scale and scores of depressed elderly were higher than that of elderly who were not depressed and these differences were statistically significant. Hopelessness was a significant predictor of suicidal ideation in the entire sample as well as in the depressed and non-depressed elderly when the two groups were considered separately. Impulsivity when considered alone was a significant predictor of suicidal ideations in the entire sample. Conclusion: Hopelessness and impulsivity both by themselves are significant predictors for suicidal ideations in the elderly and when both are considered together hopelessness is a better predictor of suicidal ideations than impulsivity.

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Aim: This study attempted to assess the incidence, prevalence, risk factors and outcome of delirium in elderly (≥60 years) patients admitted to a coronary care unit. Materials and Methods: Confusion Assessment Method for Intensive Care Unit (CAM-ICU) was used to screen the patients for delirium and those found to have delirium on CAM-ICU were subjected to a detailed evaluation by a psychiatrist to confirm the diagnosis of delirium. Additionally risk factors were assessed by using a checklist and outcome was determined. Results: One hundred and fifty two patients were evaluated for delirium. Of these, 37 (24.34%) patients had delirium at the first assessment (i.e. within 24 hours of admission in CCU) and were classified as 'prevalence cases' of delirium. Fifteen cases (13.04%) developed delirium after 24 hours of CCU stay and were considered as 'incidence cases' of delirium. Among the various risk factors studied, factors which were identified as predictors of delirium in binary logistic regression analysis were hypokalemia, Sequential Organ Failure Assessment (SOFA) score, use of warfarin, frusemide, ranitidine, benzodiazepine, opioids, steroids, more than 4/5 medications, presence of sepsis, cardiogenic shock, having undergone coronary artery bypass grafting, left ventricular ejection fraction <30, higher age, presence of uncontrolled diabetes mellitus and presence of congestive cardiac failure. Of the 52 patients who developed delirium, 10 (19.2%) died during their hospital stay, this was significantly higher than the mortality rate (1%) seen in the non-delirium group. Conclusions: In coronary care units, delirium is a common entity in elderly and is predicted by the presence of modifiable risk factors. Delirium is also associated with increased mortality.

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Aim of the Study: To study the relationship of delirium motor subtypes with cognitive and non-cognitive symptoms of delirium in geriatric patients referred to consultation-liaison psychiatry services. Materials and Methods: Ninety eight (N = 98) consecutive patients (aged ≥60 years) with diagnosis of delirium as per DSM-IV TR were rated on Delirium Rating scale-Revised-98 version (DRS-R-98) and amended Delirium motor symptom scale (DMSS). Results: On amended DMSS, hyperactive subtype (N = 45; 45.9%) was the most common motoric subtype of delirium, followed by hypoactive subtype (N = 23; 23.5%), and mixed subtype (N = 21; 21.4%). On DRS-R-98, all patients fulfilled the criteria of 'acute (temporal) onset of symptoms', 'presence of an underlying physical disorder' and 'difficulty in attention'. In the total sample, >90% of the patients had disturbances in sleep-wake cycle, orientation and fluctuation of symptoms. The least common symptoms were delusions, visuospatial disturbances and motor retardation. When compared to hypoactive group, significantly higher proportion of patients with hyperactive subtype had delusions, perceptual disturbances, and motor agitation. Whereas, compared to hyperactive subtype, significantly higher proportion of patients with hypoactive subtype had thought process abnormality and motor retardation. When the hyperactive and mixed motoric subtype groups were compared, patients with mixed subtype group had significantly higher prevalence of thought process abnormality and motor retardation. Comparison of hypoactive and mixed subtype revealed significant differences in the frequency of perceptual disturbances, delusions and motor agitation and all these symptoms being found more commonly in patients with the mixed subtype. Severity of symptoms were found to be significantly different across the various motoric subtypes for some of the non-cognitive symptoms, but significant differences were not seen for the cognitive symptoms as assessed on DRS-R-98. Conclusion: In elderly patients, motor subtypes of delirium differ from each other on non-cognitive symptom profile in terms of frequency and severity.

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