Physical morbidity in older people with moderate, severe and profound mental handicap, and its relation to psychiatric morbidity

  • S. Moss
  • D. Goldberg
  • P. Patel
  • D. Wilkin


This report describes a study of physical health problems and their relation to psychiatric morbidity in a community sample of 105 people with severe mental handicap and over the age of 50 years from a Metropolitan Borough. An extensive outreach exercise ensured that almost 100% of people fulfilling the age and ability criteria were included in the study. All the physical mental health assessments were carried out by a psychiatrist at senior registrar level. Physical assessments used a combination of physical examination and access to the subject's medical records. Results showed that, with minor exceptions, the physical health of the handicapped population was no worse than that of controls. Contrary to expectation, no relationship was demonstrated between physical and psychiatric morbidity. However, this may be due to the greater difficulty in identifying psychiatric morbidity in people who are more severely handicapped. Since physical health problems increase with level of handicap, the potential relation between physical and mental health is masked.


Mental Health Community Sample Health Assessment Psychiatric Morbidity Potential Relation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Badry DE, Vrbancic MI, McDonald L, Groeneweg G, Hornick J (1986) A demographic and needs analysis of older developmentally disabled persons in the province of Alberta. Report no. 1. Michener Centre, Faculty of Social Welfare, University of Calgary, Calgary, AlbertaGoogle Scholar
  2. Burvill PW, Mowry B, Hall WD (1990) Quantification of physical illness in psychiatric research in the elderly. Int J Geriatr Psychiatry 5:161–170Google Scholar
  3. Day K (1985) Psychiatric disorder in the middle-aged and elderly mentally handicapped. Br J Psychiatry 147:660–667Google Scholar
  4. Eastwood MR, Trevelyan MH (1972) Relationship between physical and psychiatric disorder: Psychol Med 2:363–372Google Scholar
  5. Fillenbaum (1984) The wellbeing of the elderly: Approaches to multidimensional assessment. World Health Organisation, GenevaGoogle Scholar
  6. Flynn M (1988) The social environment of adults living in their own homes. In: Flynn M (ed) A place of my own: independent living for adults who are mentally handicapped. Cassell, London, pp 71–91Google Scholar
  7. Forssman H, Akesson HO (1970) Mortality of the mentally deficient: A study of 12,903 institutionalised subjects. J Ment Defic Res 14:276–294Google Scholar
  8. Hogg J, Moss S (1989) Intellectual and adaptive functioning. A demographic study of older people with mental handicap in Oldham Metropolitan Borough, Part I. H.A.R.C. University of Manchester, ManchesterGoogle Scholar
  9. Hogg J, Moss S, Cooke D (1988) Ageing and mental handicap. Chapman and Hall, LondonGoogle Scholar
  10. Horne M (1989) A demographic study of older people with mental handicap in Oldham Metropolitan Borough, part 4. H.A.R.C., University of Manchester, ManchesterGoogle Scholar
  11. Jacobson JW, Sutton MS, Janicki MP (1985) Demography and characteristics of aging and aged mentally retarded persons. In: Janicki MP, Wisniewski HM (eds) Aging and developmental disabilities: issues and approaches pp 115–142. Paul Brookes, BaltimoreGoogle Scholar
  12. Janicki MP, Jacobson JW (1982) The character of developmental disabilities in New York State: Preliminary observations. Int J Rehabil Res 5: 191–202Google Scholar
  13. Janicki MP, MacEachron AE (1984) Residential, health, and social service needs of elderly developmentally disabled persons. Gerontologist 24:128–137Google Scholar
  14. Janicki MP, Otis JP, Puccio PS, Rettig JH, Jacobson JW (1985) Sercive needs among older developmentally disabled persons. In: Janicki MP, Wisniewski HM (eds) Aging and developmental disabilities: issues and trends pp 289–304. Paul Brookes, BaltimoreGoogle Scholar
  15. Jorm AF, Korten AE (1988) Assessment of cognitive decline in the elderly by informant interview. Br J Psychiatry 152:209–213Google Scholar
  16. Kay DWK, Bergmann K (1966) Physical disability and mental health in old age: A follow-up of a random sample of elderly people seen at home. Session 1-Psychiatric and somatic disorders in old age. J Psychosom Med 10:3–12Google Scholar
  17. Kay DWK, Roth M (1955) Physical accompaniments of mental disorders in old age. Lancet II:740–745Google Scholar
  18. Kay DWK, Beamish P, Roth M (1964) Old age mental disorders in Newcastle-upon-Tyne. Part I: A study of prevalence. Br J Psychiatry 110:146–158Google Scholar
  19. Kohn R, White KL (1976) Health care: An international study. Oxford University Press, OxfordGoogle Scholar
  20. Lindesay J (1990) The Guy's/Age Concern survey: Physical health and psychiatric disorder in an urban elderly community. Int J Geriatr Psychiatry 5:171–178Google Scholar
  21. Moss SC (1991) Age and functional abilities of people with mental handicap: Evidence from the Wessex Register. J Ment Defic Res 35:430–445Google Scholar
  22. Moss SC, Goldberg DP (1991) The Psychiatric Assessment Schedule for Adults with a Developmental Disability (the PAS-ADD): Interview development and compilation of the clinical glossary. (Project proposal to the DOH.), H.A.R.C., University of Manchester, ManchesterGoogle Scholar
  23. Moss SC, Goldberg DP, Simpson N, Patel P, Rowe S (1990) The PAS-ADD: Psychiatric Assessment Schedule modified for use in adults with developmental disabilities. H.A.R.C., University of Manchester, ManchesterGoogle Scholar
  24. Moss SC, Goldberg DP, Patel P (1991) Psychiatric and physical morbidity in older people with severe mental handicap. H.A.R.C., University of Manchester, ManchesterGoogle Scholar
  25. Moss SC, Hogg J, Horne M (1992) Demographic characteristics of a population of people with moderate severe and profound intellectual disability (mental handicap) over 50 years of age: age structure, IQ and adaptive skills. J Intellectual Disabil Res 36:387–401Google Scholar
  26. MRC (1965) Definition and classification of chronic bronchitis for clinical and epidemiological purposes Lancet I:775–779Google Scholar
  27. Murphy E (1983) The prognosis of depression in old age. Br J Psychiatry 142:111–119Google Scholar
  28. Nihira K, Foster R, Shellhaas M, Leland H (1975) AAMD Adaptive behavior manual. AAMD, WashingtonGoogle Scholar
  29. Post F (1972) The management and nature of depressive illnesses in late life: A follow-through study. Br J Psychiatry 121:393–404Google Scholar
  30. Powell C, Crombie A (1974) The Kilsyth Questionnaire: A method of screening elderly people at home. Age Ageing 3:23–28Google Scholar
  31. Reid AH (1972) Psychoses in adult mental defectives: I. Manic-depressive psychoses. Br J Psychiatry 120:205–212Google Scholar
  32. Reid AH, Aungle PG (1974) Dementia in ageing mental defectives: A clinical psychiatric study. J Ment Defic Res 18:15–23Google Scholar
  33. Reid AH, Maloney AFJ, Aungle PG (1978) Dementia in ageing mental defectives: A clinical and neuropathological study. J Ment Defic Res 22:233–241Google Scholar
  34. Rose GA (1962) Diagnosis of ischaemic heart pain and intermittent claudication. Bull WHO 27:645–658Google Scholar
  35. Roth M (1983) Depression and affective disorder in later life. In: Angst J (ed) The origins of depression. Springer, Berlin Heidelberg New YorkGoogle Scholar
  36. Roth M, Kay DWK (1956) Affectice disorder arising in the senium. II. Physical disability as an aetiological factor. J Ment Sci 102: 141–150Google Scholar
  37. Tait D (1983) Mortality and dementia among ageing defectives. J Ment Defic Res 27:133–142Google Scholar
  38. Wilkin D, Durie A, Wade G, Jolley DJ (1984) Research report no. 5 Research Section Psychogeriatric Unit, University Hospital of South Manchester, ManchesterGoogle Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • S. Moss
    • 1
  • D. Goldberg
    • 1
  • P. Patel
    • 1
  • D. Wilkin
    • 1
  1. 1.Hester Adrian Research CentreUniversity of ManchesterManchesterUK

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