title: A comparative study of elderly patients with schizophrenia and bipolar disorder in nursing homes and the community.
abstract: This study compared the functioning of 188 elderly schizophrenic and bipolar disorder patients living in nursing homes and the community. Residential status and diagnostic groups were compared on measures of symptomatology, cognitive impairment, functional impairment, and behavior problems. In general, the diagnostic groups differed in symptoms, while most differences in living setting were related to cognition, functioning, and behavior. Nursing home status was significantly associated with more severe overall symptom ratings, worse cognitive impairment, greater functional impairment, more aggressive behaviors, and marital status of having never married. Self-care skills, community living skills, and marital status were most uniquely predictive of nursing home residence. However, cognitive deficits were strongly predictive of both self-care and community living skills, explaining approximately half of the variance in these variables. The implications of these findings for the treatment of elderly patients with schizophrenia and other severe mental illnesses are discussed.
authors.affiliation: New Hampshire-Dartmouth Psychiatric Research Center, Department of Psychiatry, Dartmouth Medical School, Lebanon, New Hampshire, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Bartels
authors.forename: K T
authors.initials: KT
authors.lastname: Mueser
authors.forename: K M
authors.initials: KM
authors.lastname: Miles
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D010054:Brief Psychiatric Rating Scale; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005195:Family Relations; D015577:Geriatric Assessment; D006801:Humans; D017533:Marital Status; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011336:Probability; D011569:Psychiatric Status Rating Scales; D012494:Sampling Studies; D012559:Schizophrenia / Q000175:diagnosis* / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D012648:Self Care; D012720:Severity of Illness Index; D012944:Social Support