title: Psychiatric diagnosis and uncooperative behavior in nursing homes.
abstract: The prevalence of psychiatric disorders and behavioral disturbances in nursing homes is high, but the relationship between the two is unknown. We studied 454 new admissions who were diagnosed by research psychiatrists using DSM-III-R criteria and compared patients who nursing staff designated as cooperative or uncooperative by psychiatric diagnosis and use of restraints and neuroleptics. Uncooperative patients (n = 79; 17.4%) had a variety of psychiatric disorders (total, 87.3%) but particularly had dementia syndromes complicated by delusions, depression, or delirium (44.3%). Uncooperative patients were more frequently restrained and prescribed neuroleptics. Determining the origins of behavior disorders in patients with psychiatric disorders in nursing homes may reduce behavior disturbances.
authors.affiliation: Department of Psychiatry and Human Behavior, Thomas Jefferson University/Jefferson Medical College, Wills Eye Hospital, Philadelphia, PA 19107.
authors.forename: B W
authors.initials: BW
authors.lastname: Rovner
authors.forename: C D
authors.initials: CD
authors.lastname: Steele
authors.forename: P
authors.initials: P
authors.lastname: German
authors.forename: R
authors.initials: R
authors.lastname: Clark
authors.forename: M F
authors.initials: MF
authors.lastname: Folstein
mesh_terms: D000368:Aged; D003299:Cooperative Behavior; D003693:Delirium / Q000175:diagnosis / Q000523:psychology; D003702:Delusions / Q000175:diagnosis / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology; D009735:Nursing Homes; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D012931:Social Environment; D016312:Treatment Refusal