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Positive Psychiatry Interventions in Geriatric Mental Health

  • Geriatric Disorders (M Sajatovic and A Aftab, Section Editors)
  • Published:
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Abstract

Purpose of review

Positive psychiatry shifts the focus of geriatric mental healthcare beyond studying disorders and psychopathology to studying factors that contribute to mental well-being and successful aging. An increasing number of interventional studies are using treatments that target modifiable positive psychosocial characteristics (PPCs) and study their impact on mental health. Here we provide an overview of the literature on positive psychiatry interventions using illustrative examples of interventions targeting social connectedness, meaning in life, wisdom, and resilience.

Recent findings

There is growing evidence that PPCs are modifiable constructs that may be associated with improved well-being, physical health, and mental health outcomes.

Summary

The preliminary evidence summarized in this narrative review indicates that positive psychiatry interventions targeting social connectedness, meaning in life, wisdom, and resilience can improve overall well-being and other positive health outcomes amongst older adults. The effect sizes of these interventions reported in RCTs and meta-analyses are typically small to medium, but occasionally large effect sizes are also reported. Current literature is restricted by heterogeneous methodology, limiting clinicians’ abilities to extrapolate these principles of positive psychiatry into everyday practice. With the expanding body of evidence, positive psychiatry may have the potential to transform the landscape of geriatric mental health.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Warren Alpert Medical School, Brown University, Providence, RI, USA

    Jeffrey Lam BA

  2. Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA

    Awais Aftab MD

  3. Northcoast Behavioral Healthcare (Ohio Department of Mental Health and Addiction Services), Northfield, OH, USA

    Awais Aftab MD

  4. Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA

    Ellen Lee MD & Dilip Jeste MD

  5. Department of Psychiatry, University of California San Diego, La Jolla, CA, USA

    Ellen Lee MD & Dilip Jeste MD

  6. Veterans Affairs San Diego Healthcare System, San Diego, CA, USA

    Ellen Lee MD

  7. Department of Neurosciences, University of California San Diego, La Jolla, CA, USA

    Dilip Jeste MD

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Glossary of Key Terms

Glossary of Key Terms

Meaning in Life—A positive characteristic reflecting an individual’s perception of life and activities, the value and importance ascribed to them, and the degree to which they generate a sense of meaningfulness or purpose [46].

Positive Psychiatry—A branch of medicine and psychiatry that seeks to understand and promote well-being through assessment and interventions improving positive psychosocial characteristics in individuals who suffer from or are at high risk of developing mental or physical disorders [4].

Positive Psychology—A branch of psychology that seeks to achieve scientific understanding of positive human functioning and develop interventions to enhance well-being and flourishing in individuals, families, and communities.

Positive Psychology and Positive Psychiatry Interventions—Scientific interventions and designed activities that aim to increase well-being by cultivating positive feelings, behaviors, or cognitions [10].

Social Connectedness—A positive characteristic measuring the degree to which an individual has close meaningful, and constructive relationships with others. The opposite of loneliness (subjective distress arising from discrepancy between desired and perceived social relationships) and social isolation (objective absence of social contacts).

Resilience—A positive characteristic measuring the degree to which an individual can adapt well in the face of adversity, trauma, tragedy, threats, or significant sources of stress [83].

Wisdom—A positive grouping of characteristics within an individual that includes an having (1) knowledge of life and social advising, (2) prosocial attitudes and behaviors (e.g., empathy, compassion, altruism), (3) self-understanding, (4) acceptance of uncertainty and divergent values, (5) emotional regulation, and (6) decisiveness [64].

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Lam, J., Aftab, A., Lee, E. et al. Positive Psychiatry Interventions in Geriatric Mental Health. Curr Treat Options Psych 7, 471–488 (2020). https://doi.org/10.1007/s40501-020-00228-6

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  • DOI: https://doi.org/10.1007/s40501-020-00228-6

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