O-20 - Somatoform disorders in later life population

Abstract

Although clinicians are faced with the problem of somatisation throughout the lifespan, little research has concentrated on somatoform disorders and Medically Unexplained Symptoms (MUS) in older people. 1. To estimate the prevalence of somatoform disorders and MUS in later life. 2. To examine geriatric and psychiatric morbidity in older persons referred for medically unexplained symptoms. First, a systematic literature search was performed on the prevalence of somatoform disorder and MUS. Subsequently, a consecutive case series of 37 patients referred for MUS to a multidisciplinary outpatient clinic at a secondary care mental health center in the Netherlands. A total of 7 studies were found that specifically addressed prevalence rates for somatoform disorders among older persons. Younger (< 50 years) and middle aged (50–65 years) patients had similar, and older patients substantially lower prevalence rates of somatoform disorders. Prevalence rates for MUS showed wider ranges within each age strata due to use of different definitions and instruments.In our convenience sample of 37 elderly patients with MUS, 32 did have a somatoform disorder. These 32 patients had high levels of psychiatric comorbidity, i.e. depressive disorders (n = 18, 56%), anxiety disorders (n = 10, 31%), and substance use (n = 6, 19%). Although somatoform disorders are common in later life, reported prevalence rates decline with age. This might be an artifact due to diagnostic difficulties due to increased rates of somatic comorbidity with increasing age. This diagnostic complexity and the high prevalence of psychiatric morbidity argues for a multidisciplinary approach in later life.