Geriatric Psychiatry Clinic Research Articles

Predictors of Engagement in an Urban Geriatric Psychiatry Clinic

The authors performed a chart review of 174 patients age 50 and over (mean age, 69 years) to test a model of social and clinical characteristics that predict engagement in outpatient treatment. “Engaged” patients were defined as those who had three or more clinic visits. Logistic regression analysis, using a 14-variable model, was highly significant (P = 0.0003) and able to correctly classify 70% of cases. There were four predictors of clinical engagement: being a Medicaid recipient (P < 0.01), shorter length of current symptoms (P < 0.05), younger age (P = 0.06), and having a diagnosis of schizophrenia (P = 0.06); and these variables accounted for all the explained variance. These findings indicated that predictors of engagement do not invariably follow the patterns reported for younger patients. The authors performed a chart review of 174 patients age 50 and over (mean age, 69 years) to test a model of social and clinical characteristics that predict engagement in outpatient treatment. “Engaged” patients were defined as those who had three or more clinic visits. Logistic regression analysis, using a 14-variable model, was highly significant (P = 0.0003) and able to correctly classify 70% of cases. There were four predictors of clinical engagement: being a Medicaid recipient (P < 0.01), shorter length of current symptoms (P < 0.05), younger age (P = 0.06), and having a diagnosis of schizophrenia (P = 0.06); and these variables accounted for all the explained variance. These findings indicated that predictors of engagement do not invariably follow the patterns reported for younger patients.

Therapeutic activity and health status

Professor of Occupational Therapy Assistant Professor of Psychiatry Occupational Therapy Program Director Geriatric Psychiatry and Behavioral Neurology Module Western Psychiatric Institute and Clinic University of Pittsburgh Pittsburgh, Pennsylvania

DSM III diagnosis in the geropsychiatric patient.

This article reviewed thc theoretical underpinnings of the DSM 1U classification system, with particular emphasis on psychogeriatric practice. Advantages of a descriptive approach, use of operational criteria, and the utility of a multiaxial system in developing comprehensive treatment programs were examined. A retrospective study, one year after the implementation of DSM 111, was conducted on all consecutive admissions to a geriatric psychiatry clinic. The available data suggest: (1) a high incidence of patients with predominant paranoid symptomatology are classified as atypical disorders; (2) paranoid disorder subtypes need to be expanded or clarified, (3) mania does not burn out with age; and (4) schizophrenic disorders are less frequently diagnosed because of restrictive age of onset and illness duration criteria. Recommendations for overcoming these problems were presented.