title: Demoralisation, distress and pain in older Western Australians.
abstract: OBJECTIVE
  To assess the relationship of psychiatric morbidity, morale, physical activity and the presence of pain in older people.
  
  
  METHODS
  Older people attending senior citizens' clubs were administered the 28-item General Health Questionnaire (GHQ-28), the Revised Philadelphia Geriatric Centre Scale (RPGCS) and five self-report questions from the Brief Disability Questionnaire. They also rated the presence of pain on a five-point scale. Multiple and logistic regression were used to adjust for socio-demographic factors and identify variables independently associated with psychological status and morale.
  
  
  RESULTS
  Of 112 people approached, 86% agreed to take part (n = 96). The sample showed a wide range in total GHQ scores (mean = 2.9, range = 0-19) and RPGCS scores (mean = 2.3, range = 1.1-3.0). Twenty-one per cent had psychological distress as defined by a score of > or = 6 on the GHQ-28 (n = 19). Fifty-four respondents (56%) reported low morale as defined by a score < 2 on the RPGCS. There was a close relationship between psychological distress, low morale on the RPGCS (OR = 5.5 [1.5-20.5]) and moderate to severe pain (OR = 5.3 [1.8-15.9]). When adjusted odds ratios were calculated to control for confounding factors, moderate to severe pain remained independently associated with psychological distress (OR = 1.6 [1.3-2.4] p = 0.02), and limitations in daily activities with low morale (OR = 3.64 (1.001-8.4) p = 0.05).
  
  
  CONCLUSIONS
  There is a close relationship between physical disability, low morale and psychological distress.
  
  
  CONCLUSIONS
  An increased index of suspicion for psychological distress is warranted in all older people with physical disability, particularly in the presence of moderate to severe pain.
authors.affiliation: Primary Care Mental Health Unit, University of Western Australia, Fremantle. stephenk@cyllene.uwa.edu.au
authors.forename: S R
authors.initials: SR
authors.lastname: Kisely
authors.forename: P
authors.initials: P
authors.lastname: Shannon
mesh_terms: D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D015444:Exercise / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009013:Morale; D016017:Odds Ratio; D010146:Pain / Q000453:epidemiology*; D013315:Stress, Psychological / Q000453:epidemiology*; D014904:Western Australia