Magazine article Clinical Psychiatry News

Elderly Psychiatric Patients Often Overlooked or Misdiagnosed

Magazine article Clinical Psychiatry News

Elderly Psychiatric Patients Often Overlooked or Misdiagnosed

Article excerpt

A common perception, based on relatively few published studies, is that most psychiatric disorders other than depression occur much less frequently among the elderly. Community samples, however, suggest that many older adults who experience clinically significant pathologies are overlooked or misdiagnosed, according to Dilip V Jeste, M.D., and colleagues.

This discrepancy points out the need to develop age-appropriate diagnostic criteria that can assess elderly psychiatric patients, according to Dr. Jeste of the department of psychology at the University of California, San Diego, and associates (Biol. Psychiatry 2005;58:265-71).

Five potential causes of diagnostic confusion in the elderly were detailed:

* True age-related differences, in which symptoms of the disorder vary according to age. In such cases, application of DSM-IV criteria sets based on the disorder at a younger age results in under-, over-, or misdiagnosis when applied to the elderly.

* Physical and psychiatric comorbidities, which tend to occur more frequently in the elderly, including general medical conditions such as congestive heart failure or cognitive deficiencies such as dementia.

* Underreporting of symptoms, which occurs more frequently in the elderly, biasing both epidemiologic and clinical-based studies in the direction of underdiagnosis. …

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