Assessing psychiatric illness in geriatric patients

Clinical Cornerstone
L Tune

Abstract

Assessing psychiatric illness in geriatric patients can be difficult for a variety of reasons. First, medical comorbidity may obscure the diagnosis. For example, the patient with multiple chronic illnesses will often have many "vegetative" symptoms of either dementia or depression (e.g., fatigue, loss of energy, poor appetite) attributed to the primary medical condition rather than to an underlying psychiatric illness. Second, the phenomenology of psychiatric illness in the elderly is often different. For example, depression in the elderly is often characterized by prominent anhedonia--loss of interest in virtually everything--and physical complaints leading to an unnecessary medical workup. Third, physicians are often reluctant to diagnose new-onset mental illness in their elderly patients. The fear of stigmatizing the patient or physician discomfort with "psychologic language" often results in underdetection of straightforward psychiatric syndromes. This article will focus primarily on detection of 3 of the most common psychiatric syndromes: dementia, depression, and delirium. The field of geriatric psychiatry has done a good job of characterizing the prevalence (Table I) and clinical features of these syndromes. The problem-...Continue Reading

References

Jan 1, 1991·International Psychogeriatrics·S LevkoffD A Evans
Mar 1, 1997·Alzheimer Disease and Associated Disorders·A J LernerR P Friedland
Jan 23, 1999·Journal of Geriatric Psychiatry and Neurology·S K Inouye
Mar 4, 1999·The New England Journal of Medicine·S K InouyeL M Cooney
Sep 4, 1999·Dementia and Geriatric Cognitive Disorders·R C van der Mast
Dec 13, 2000·International Journal of Geriatric Psychiatry·S BorsonA Dokmak

Related Concepts

Diagnosis, Psychiatric
Differential Diagnosis
Questionnaire Design
Geriatric Assessment

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