Correlates of psychotic symptoms among elderly outpatients.
Psychotic symptoms presenting in late life can offer a diagnostic challenge to the clinician. In this study, 140 geriatric outpatients were prospectively examined for psychotic symptoms and assessed on a number of demographic and clinical variables. Cognition was assessed using the Mini-Mental State Exam. Psychiatric diagnoses were made by DSM-III-R criteria. Twenty-seven per cent (N = 38) had psychotic symptoms, delusions being the most common type. Patients with psychosis were significantly more likely to have a previous history of psychosis, to have a lower MMSE and to live in a nursing home. Four diagnoses accounted for 79.5% of all psychotic patients. In order of frequency, these were dementia, major depression, delirium and organic psychosis (organic hallucinosis, organic delusional disorder). Psychotic patients were significantly more likely to have a diagnosis of dementia, delirium or organic psychosis than non-psychotics, but depression was significantly more likely to occur in patients without psychosis. Although psychotic symptoms occur in a variety of illnesses, elderly patients with psychosis should be carefully evaluated for these disorders.
Holroyd
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Department of Psychiatric Medicine, University of Virginia Health Sciences Center, Charlottesville, USA.
Laurie
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S
D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005852:Geriatric Psychiatry / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000453:epidemiology; D010045:Outpatients / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D012494:Sampling Studies; D014481:United States / Q000453:epidemiology; D014768:Virginia / Q000453:epidemiology