Journal of General Internal Medicine

, Volume 14, Issue 4, pp 249–254

Psychiatric disorders in older primary care patients

  • Jeffrey M. Lyness
  • Eric D. Caine
  • Deborah A. King
  • Christopher Cox
  • Ziggy Yoediono
Original Articles

DOI: 10.1046/j.1525-1497.1999.00326.x

Cite this article as:
Lyness, J.M., Caine, E.D., King, D.A. et al. J GEN INTERN MED (1999) 14: 249. doi:10.1046/j.1525-1497.1999.00326.x

Abstract

OBJECTIVE: Most older people with psychiatric disorders are never treated by mental health specialists, although they visit their primary care physicians regularly. There are no published studies describing the broad array of psychiatric disorders in such patients using validated diagnostic instruments. We therefore characterized Axis I psychiatric diagnoses among older patients seen in primary care.

DESIGN: Survey of psychopathology using standardized diagnostic methods.

SETTING: The private practices of three board-certified general internists, and a free-standing family medicine clinic.

PARTICIPANTS: All patients aged 60 years or older who gave informed consent were eligible.

MEASUREMENTS AND MAIN RESULTS: For the 224 subjects completing the study, psychiatric diagnoses were based on the Structured Clinical Interview for DSM-III-R. Point prevalence estimates used weighted averages based on the stratified sampling method. For the combined sites, 31.7% of the patients had at least one active psychiatric diagnosis. Prevalent current disorders included major depression (6.5%), minor depression (5.2%), dementia (5.0%), alcohol abuse or dependence (2.3%), and psychotic disorders (2.0%). Dysthymic disorder and primary anxiety and somatoform disorders were less common and frequently comorbid with major depression.

CONCLUSIONS: Mental disorders, particularly depression, are common among older persons seen in these primary care settings. Clinicians should be particularly vigilant about depression when evaluating older patients with anxiety or putative somatoform symptoms, given the relatively low prevalences of primary anxiety and somatoform disorders.

Key words

psychopathology depression elderly primary care 

Copyright information

© Society of General Internal Medicine 1999

Authors and Affiliations

  • Jeffrey M. Lyness
    • 1
  • Eric D. Caine
    • 1
  • Deborah A. King
    • 1
  • Christopher Cox
    • 1
    • 2
  • Ziggy Yoediono
    • 1
  1. 1.the Program in Geriatrics and Neuropsychiatry, Department of PsychiatryUniversity of Rochester School of Medicine and DentistryRochester
  2. 2.Department of BiostatisticsUniversity of Rochester School of Medicine and DentistryRochester

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