Psychiatric case-identification in an elderly urban population

Summary

As part of a field-study of mental disorders in an elderly population, a random sample of over-65 year old residents of seven selected districts of Mannheim, Federal Republic of Germany, were examined using a standard method, the Clinical Psychiatric Interview Schedule, adapted for this purpose. A preliminary analysis has been carried out on data for 312 elderly community residents and for 30 elderly psychiatric hospital patients, admitted from the survey districts. The frequency distribution for a weighted total item-score conforms to a typical skewed unimodal curve. There is no evidence of a natural division between mentally ill and mentally healthy sections of the elderly population. Using an operational case-definition based on three interrelated clinical criteria, a frequency rate for all forms of psychiatric disorder of 24.0% was obtained. The results of a cluster analysis provided some support for the clinical procedure in case-identification as well as for the main diagnostic groupings. In a further analysis, the sample was allocated to sub-groups defined by 1. psychiatric status, 2. physical health and capacity for self-care and 3. type of living-group, as a first step towards estimating the need for various types of special service in the elderly population.