Differential Diagnosis: Depression Versus Dementia
Post (1951) and Roth and Morrisey (1952) drew attention to the importance of distinguishing between depressive illness and dementia in hospital samples of elderly persons aged over 65. They pointed to the difficulty of making the distinction and its important prognostic implications. Kramer (1961) had reported differences between the diagnostic frequencies for first admissions of the elderly to US state hospitals and Area mental hospitals in England and Wales. Organic disorders appeared to be almost twice as frequent among US admissions than UK admissions, in contrast to functional disorders, which comprised only about one-sixth of the proportion entering the UK hospitals. Kramer was concerned that numbers of functional disorders, particularly depression, were being diagnosed as organic disorders in American hospitals. The available statistics also showed that patients admitted to US hospitals were twice as likely to die in the hospital within 1 year of admission than those admitted to British hospitals, while British elderly patients appeard three times more likely than their US counterparts to be discharged within 1 year.
KeywordsDepressive Illness Organic Disorder Organic Case Geriatric Hospital Acute Confusional State
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