Old age and aging the present status of scientific knowledge: Section meeting, 1939: Psychiatric aspects of old age and aging.

Abstract

HE psychiatric pictures occurring in old age can only be understood if one T takes the psychology of aging into consideration. The psychiatrist observes that human beings between 40 and 50 start to think about the coming of old age. There is the gradual change in appearance; the hair may start to gray and there may be a feeling of a diminished capacity for physical work. I n women, the menopause is generally considered as the end of one period of life and the beginning of a less desirable period. The individuals may feel that their erotic value is diminishing. If life has been satisfactory and there is a prospect of continued emotional and social security, they will feel that their values as personalities have not diminished and that they can still enjoy the importance which their greater experience and social power bestow upon them. When, later on, the impairment of sensory functions and motor performances become undeniable, and when the decline in memory functions and creative mental capacities also becomes obvious to the individuals themselves, they may be easily resigned to looking back on the experiences and achievements of their life spans. They may still feel sure of their inner value in relation to their families or surroundings in general. We may expect that some individuals will be unable to stand their losses by age, and may then revolt by complaining. Others will answer to the deprivation by giving up completely and, finally, there will be a group who will try to find compensation in a fantasy world which may be an illicit revival of the past, and which may deviate in one or the other direction from reality. We may speak about two phases in aging and call the first, the phase of libidinous rearrangement; the second, the phase of organic impairment.Modern psychiatry is accustomed to view psychotic manifestations not as queer additions to the so-called 'normal' personality, but as specific aspects of psycho-physiological developments which, in essence, are identical in the normal and in the pathological case. We may, therefore, classify the psychoses of aging persons in two large groups. The first group does not show 'organic' changes. There are no definitely abnormal autopsy findings in the brain. Clinically we do not find an impairment of intellect and memory. Two main subgroups can be differentiated: (I) depressive pictures: (2) paranoid pictures. Of less importance are the chronic manic pictures (Wertham, 1).The second group is the organic group which can be differentiated according to several principles. One may differentiate the forms with localized defects from the forms with generalized and diffuse defects. However, the aphasias and agnosias due to localized lesions are not so much the concern of this discussion. One may also differentiate (I) presenile deteriorations from (2) senile deteriorations. To the presenile group belongAlzheimer's and Pick's diseases and, in some sense, Huntington's chorea also. To the senile group would belong senile deterioration as such. Furthermore, there belong her...

Concepts and criteria of mental health and aging.

“…Documentation is available for the conclusion that, in relation to need, the population over the age of 65 is receiving only a small fraction of mental health service^.^. 2 1 Since the child-centered point of view has pervaded educational and training institutions, few if any professionals have received appropriate training for dealing with the issues of the second half of life. Professionals therefore can be disconcerted when faced with older adults, and the choice of service is made in favor of children or young adults.…”

Concepts and criteria of mental health and aging.

“…Documentation is available for the conclusion that, in relation to need, the population over the age of 65 is receiving only a small fraction of mental health service^.^. 2 1 Since the child-centered point of view has pervaded educational and training institutions, few if any professionals have received appropriate training for dealing with the issues of the second half of life. Professionals therefore can be disconcerted when faced with older adults, and the choice of service is made in favor of children or young adults.…”

Concepts and criteria of mental health and aging.

“…Documentation is available for the conclusion that, in relation to need, the population over the age of 65 is receiving only a small fraction of mental health service^.^. 2 1 Since the child-centered point of view has pervaded educational and training institutions, few if any professionals have received appropriate training for dealing with the issues of the second half of life. Professionals therefore can be disconcerted when faced with older adults, and the choice of service is made in favor of children or young adults.…”

Concepts and criteria of mental health and aging.

“…Documentation is available for the conclusion that, in relation to need, the population over the age of 65 is receiving only a small fraction of mental health service^.^. 2 1 Since the child-centered point of view has pervaded educational and training institutions, few if any professionals have received appropriate training for dealing with the issues of the second half of life. Professionals therefore can be disconcerted when faced with older adults, and the choice of service is made in favor of children or young adults.…”