Mental Disorders in Patients at Geriatrician Attendance: Basic Variants and Influence on Social Functioning (The Experience in Russia)

Abstract

Introduction: Data exists showing a significant prevalence of mental disorders in the growing elderly population, but indices have a fairly wide range. This study’s aim was to analyze the frequency and variants of such disorders of the elderly in geriatrician attendance and their influence on social functioning.

Material and methods: Of newly-admitted geriatrician patients, 37.2% were found to have deviations at the time of screening (Geriatric Depression Scale, Zung anxiety scale, MMSE and the clock drawing test). Of these 32 patients (24 women) were 69.5±4.4 years old and had somatic illnesses, mainly cardiovascular diseases and diabetes. The detailed assessment included the Neuropsychiatric Inventory Questionnaire, the Clinical Global Assessment, and the Global Assessment of Functioning scales. Statistics were based on Student-s criterion (taking into account the normal distribution of the sample data).

Results and their discussion: Fully 93.7% of the disorders met the International Classification of Diseases (10th edition) criteria for adaptation disorder, organic anxiety disorder, recurrent depressive disorder with a moderate depressive episode. Two patients had dementia with confusion (delirium). The significant ranking of the anxiety-depressive disorders can be explained by their prevalence in the elderly population as a whole, the close relationship of such disorders with somatic pathology, and in dementia and psychotic cases, more frequent visits to psychiatrists. About a third of the patients manifested signs of impaired functioning, dependent on the presence of family (t = 2.9; p < 0.05) and their relationships within the family (the complex ones excluded indices above 70 points of GAF).

Conclusions: More than a third of newly-admitted geriatric patients have mental disorders, mostly those on the anxiety-depressive depressive spectrum. Biological factors and psychosocial influences are both present represented as their reasons. Social functioning may suffer and highly depends on microsocial environments.