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OLD AGE PSYCHIATRY FOR PRIMARY CARE VOCATIONAL TRAINEES

OLD AGE PSYCHIATRY FOR PRIMARY CARE VOCATIONAL TRAINEES. Dr Nick Pearson Consultant in the Psychiatry of Old Age Reading 280206. Older Person’s Mental Disorders in Primary Care. The Dynamic Duo Depression Dementia. Older Persons’ Depressive Disorders in Primary Care.

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OLD AGE PSYCHIATRY FOR PRIMARY CARE VOCATIONAL TRAINEES

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  1. OLD AGE PSYCHIATRY FOR PRIMARY CARE VOCATIONAL TRAINEES Dr Nick Pearson Consultant in the Psychiatry of Old Age Reading 280206

  2. Older Person’s Mental Disorders in Primary Care • The Dynamic Duo • Depression • Dementia

  3. 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% > 65 yrs (340) • Depressed patients= 42 • Treatment Resistant= 14

  4. Older Person’s Depression in Primary Care • 15-30% seek help • Prevalence Care homes 30-40% • Nursing homes 70% • General hospitals 15-20%

  5. Older Persons’ Dementia in Primary Care • Prevalence >65 yrs= 5% • Patients with dementia average GP caseload-17 • 1in 10 receive a diagnosis • >75yrs=10% • >85 yrs= 20% • >90yrs= 30%

  6. 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

  7. Older Person’s Mental Disorders in Primary Care • Younger onset dementia • 1in 1000 < 65yrs • 0.3 of a person

  8. Older Persons’ Delirium in Primary Care • Prevalence in primary care unknown • 40% of>65yrs in hospital

  9. Older Persons’ Psychotic Disorders in Primary Care • Psychotic Disorders • Prevalence in community >65yrs of 1% • Schizophrenia • Persistent delusional disorders • Mania • Psychotic depression

  10. 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%

  11. Older Persons’ Neurosis in Primary Care • Prevalence anxiety disorders>65yrs= 4% • Phobias= 10%

  12. Older Persons’ Psychoactive Substance Use in Primary Care • 4% of older males had drunk> 8 units of alcohol on at least 1 day in the previous week. • 16-24yr olds? • Alcohol more commonly a complicating factor

  13. Older Persons’ Mental Disorders in Primary Care: Factors • Physical disorders • Medication • Social Context • Environmental Context • Individual’s meaning

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