OLD%20AGE%20PSYCHIATRY%20FOR%20PRIMARY%20CARE%20VOCATIONAL%20TRAINEES - PowerPoint PPT Presentation
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OLD%20AGE%20PSYCHIATRY%20FOR%20PRIMARY%20CARE%20VOCATIONAL%20TRAINEES
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Title: OLD%20AGE%20PSYCHIATRY%20FOR%20PRIMARY%20CARE%20VOCATIONAL%20TRAINEES
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OLD AGE PSYCHIATRY FOR PRIMARY CARE VOCATIONAL
TRAINEES
- Dr Nick Pearson
- Consultant in the Psychiatry of Old Age Reading
- 280206
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Older Persons Mental Disorders in Primary Care
- The Dynamic Duo
- Depression
- Dementia
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Older Persons Depressive Disorders in Primary
Care
- Depression in older age is not an inevitable
consequence it is a pathological state - 10-15 over 65yrs
- GP list of 1700 20 gt 65 yrs (340)
- Depressed patients 42
- Treatment Resistant 14
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Older Persons Depression in Primary Care
- 15-30 seek help
- Prevalence Care homes 30-40
- Nursing homes 70
- General hospitals 15-20
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Older Persons Dementia in Primary Care
- Prevalence gt65 yrs 5
- Patients with dementia average GP caseload-17
- 1in 10 receive a diagnosis
- gt75yrs10
- gt85 yrs 20
- gt90yrs 30
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Older Persons Dementia in Primary Care
- Significant Behavioural and Psychological
Symptoms in Dementia BPSD (30) 5 - Mild to moderate (2/3) 11
- May benefit from treatment (3/4) 8
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Older Persons Mental Disorders in Primary Care
- Younger onset dementia
- 1in 1000 lt 65yrs
- 0.3 of a person
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Older Persons Delirium in Primary Care
- Prevalence in primary care unknown
- 40 ofgt65yrs in hospital
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Older Persons Psychotic Disorders in Primary Care
- Psychotic Disorders
- Prevalence in community gt65yrs of 1
- Schizophrenia
- Persistent delusional disorders
- Mania
- Psychotic depression
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Older Persons Psychotic Disorders in Primary Care
- Severe
- Lethal
- for 65-86 yr olds over a 6 yr period mortality
men 30 women 20 - Psychotic depression men 75 women 40
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Older Persons Neurosis in Primary Care
- Prevalence anxiety disordersgt65yrs 4
- Phobias 10
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Older Persons Psychoactive Substance Use in
Primary Care
- 4 of older males had drunkgt 8 units of alcohol
on at least 1 day in the previous week. - 16-24yr olds?
- Alcohol more commonly a complicating factor
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Older Persons Mental Disorders in Primary Care
Factors
- Physical disorders
- Medication
- Social Context
- Environmental Context
- Individuals meaning
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