Comprehensively diagnosing geriatric patients

Abstract

An attempt to explore and document the descriptive usefulness of a biopsychosocial diagnostic approach represented by the Diagnostic and Statistical Manual of Mental Disorders (ed 3) (DSM-III) multiaxial system was conducted by comparing semistructured evaluations of 494 new consecutive geriatric patients with those of 4,354 younger adult counterparts. A wide diversity of psychiatric disorders were found among geriatric patients, almost as wide as among younger adults. Organic mental disorders (except those induced by substances) and recurrent major depression were the most frequently diagnosed conditions in the geriatric sample, in which 19% of the patients had dementia and depressive disorders listed together as either firm or rule/out diagnoses. A combined salience was also found in this sample for physical disorders (particularly, circulatory, endocrine and neurological conditions), their high psychosocial impact, and poorer levels of adaptive functioning. The findings emphasize the importance of comprehensive diagnostic models for geriatric patients and their implications for multidimensional intervention strategies.