‘Sadly confused’: the detection of depression and dementia on medical wards

Abstract

Dementia and depression are common psychiatric diagnoses in older people, and are common reasons for referral to liaison psychiatry services. The present study examined the accuracy of physicians' diagnoses for both disorders in consecutive referrals to a liaison old age psychiatry service. RESULTSPositive predictive values for depression and dementia were high, but levels of treatment of depression and documentation of past psychiatric history were both poor. Alcohol misuse and stroke accounted for the commonest accompanying disorders. CLINICAL IMPLICATIONSThe findings have implications for the encouragement of physicians to treat depression when this is suspected. Educational programmes for this purpose may be useful, incorporating an exploration of attitudes and knowledge of physicians towards depression in older people.

Mental capacity assessments among general hospital inpatients referred to a specialist liaison psychiatry service for older people

“…This proportion is higher than that reported for general adult liaison services in the U.S.A. (Jourdan and Glickman, 1991;Knowles et al, 1994). Two U.K. reports suggested that referrals for mental capacity assessment were either uncommon (Benbow and Dawson, 1996) or were not made at all (Rao, 2001). Two U.K. reports suggested that referrals for mental capacity assessment were either uncommon (Benbow and Dawson, 1996) or were not made at all (Rao, 2001).…”

The birth of a specialty: the first ten thousand patients of an old age psychiatry service

“…Unfortunately, the data do not allow us to readily differentiate these sources; from data on detection rates it seems that elderly care physicians at least are accurate in their diagnoses (Rao, 2001). However, there is a strong perception that hospital physicians have in the past been prone to refer some patients to our service more in desperation than in hope, and this has partly stimulated the genesis recently of specialist liaison-psychiatry services for elderly adults.…”

Nurse-led liaison psychiatry service for older adults: service evaluation

“…The most common referring problem was confusion. Other problems included a mood disorder, self-harm, capacity assessment, anxiety and assessment of placement, and compares similarly with other surveys (Rao, 2001;Ashaye et al, 2006). The rate of self-harm (4%) was comparable with that in other services (Gash et al, 2005).…”