Psychiatric disorders in older primary care patients.
OBJECTIVE
Most older people with psychiatric disorders are never treated by mental health specialists, although they visit their primary care physicians regularly. There are no published studies describing the broad array of psychiatric disorders in such patients using validated diagnostic instruments. We therefore characterized Axis I psychiatric diagnoses among older patients seen in primary care.


METHODS
Survey of psychopathology using standardized diagnostic methods.


METHODS
The private practices of three board-certified general internists, and a free-standing family medicine clinic.


METHODS
All patients aged 60 years or older who gave informed consent were eligible.


RESULTS
For the 224 subjects completing the study, psychiatric diagnoses were based on the Structured Clinical Interview for DSM-III-R. Point prevalence estimates used weighted averages based on the stratified sampling method. For the combined sites, 31.7% of the patients had at least one active psychiatric diagnosis. Prevalent current disorders included major depression (6.5%), minor depression (5.2%), dementia (5.0%), alcohol abuse or dependence (2. 3%), and psychotic disorders (2.0%). Dysthymic disorder and primary anxiety and somatoform disorders were less common and frequently comorbid with major depression.


CONCLUSIONS
Mental disorders, particularly depression, are common among older persons seen in these primary care settings. Clinicians should be particularly vigilant about depression when evaluating older patients with anxiety or putative somatoform symptoms, given the relatively low prevalences of primary anxiety and somatoform disorders.
Lyness
J M
JM
Program in Geriatrics and Neuropsychiatry, Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY, USA.
Caine
E D
ED
King
D A
DA
Cox
C
C
Yoediono
Z
Z
D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D011320:Primary Health Care