It is commonly thought and taught that most psychiatric disorders other than dementia
are much less prevalent among the elderly than among younger adults. This perception
is based on a relatively small number of published epidemiologic investigations of
the incidence and prevalence of mental illnesses in elderly populations. Most of these
studies have had a number of methodologic problems, including improper definitions
and diagnostic criteria for older persons. A likely consequence of these misconceptions
is that clinically significant and potentially treatable mental illnesses might be
overlooked, misdiagnosed, and mistreated in elderly patients. Studies in community
samples suggest that many older adults who experience clinically significant psychopathology
do not fit easily into our existing nomenclature, and yet are disabled. There is a
need to develop aging-appropriate diagnostic criteria for major psychiatric disorders.
In this article, we discuss the potential causes of this diagnostic confusion. Four
specific classes of disorders—mood (specifically depressive) disorders, schizophrenia
(and related psychotic disorders), anxiety disorders, and substance use disorders—are
discussed as examples. Finally, we suggest some future steps for clarifying this diagnostic
confusion.
Key Words
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Article info
Publication history
Published online: April 13, 2005
Accepted:
February 2,
2005
Received in revised form:
January 27,
2005
Received:
November 12,
2004
Identification
Copyright
© 2005 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
