[Mental Health of elderly people: The prevalence and representations of psychiatric disorders].
Upon the national data basis of the huge study "Mental Health in General Population", elaborated by the WHO Collaborating Centre, our research tries to identify the particularities of the advanced years population. The increasing number of the elderly in France and all over the world, as well as the demographic evolution prospects, truly justify our interest for them. A group of subjects older than 65 years old - representing 21,1% of the general population - was divided into two parts and the 65-74 years old (12.6%) - the 75 old years old and more (8.5%) - and was compared to the population between 18 and 74 years old (78.9%) who answered this investigation. The aim of our study was to detect the prevalence of the main psychic troubles of the elderly (depression, anxiety, addiction and psychiatric disorders), with a psychiatric tool, the Mini International Neuropsychiatric Interview (MINI). We also wanted to perceive how their perceptions and representations of the behaviours and clinical symptoms of the psychic troubles could be different from the ones of younger people. Thus, and according to the answers "normal/abnormal", "dangerous/not dangerous" linked to each item, we measured the possible difference between the answers and the representations of the general population towards the elderly. The elderly are generally confronted to multiple psychosocial stress factors (decrease of the cognitive performances, decline of the sensory abilities, drop of the social relationships, change of status, succession of loss and breach as well as the cessation of the professional activity and its network, which may favour the emergence of troubles. According to this, a higher rate of psychic troubles among the elderly than in the general investigated population, may be suspected. However, the study in general population points out that the prevalence of persons suffering from at least one trouble with the MINI declines among the subjects belonging to the highest brackets: 34.4% for the 18-64 years old, 23.2% for the 65-74 years, and 22.9% for the elderly, 75 years old and more. Anxiety decreases with the ageing (23.4% among the less than 65 years old, instead of 12.7% for the 75 years and more) as well as the addictive behaviours and the psychotic disorders (3.1% for the less than 65 years old, instead of 1.1% for the 75 years old and more). In the register of the social representations, a few differences appear also between the elderly - from 65 to 74 years old and 75 years old and more - and the majors under 65 years old: For the spectrum: T.P.S.A (sadness, tears, suicide, anxiety), the elderly consider these situations as pathological more often. The withdrawal behaviours are likely more perceived as "abnormal" by the elderly; The delusion, the hallucinations, the "odd" behaviours and talks are less often called "dangerous/non-dangerous", which leads to a rather different way of considering the elderly. Paramount the classical allowed image of the elderly - fearful, distrustful, intolerant towards any transgression and selfishly centred on their own the study reveals new conditions particularly in pointing out, among the elderly, less fear towards violent behaviours and more toleration towards the addicted subjects.
Giordana
J Y
JY
Pôle de psychiatrie Générale, Centre Hospitalier Sainte Marie, Nice. jean-yves-giordana@nice-groupe-sainte-marie.com
Roelandt
J L
JL
Porteaux
C
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003617:Dangerous Behavior; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005602:France; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011639:Public Opinion; D012933:Social Identification; D012944:Social Support; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D014944:World Health Organization; D055815:Young Adult