Eighty-one patients (mean age: 66 +/- 9 years) who had been in gerontopsychiatric in-patient care were included in the study. As well as physical, psychiatric and neurological examinations, EEG, brain CT scanning and the determination of the Ischemic Scale were performed, in order to confirm the clinical diagnosis of dementia of Alzheimer type (DAT), dementia of vascular type (DVT) or multi-infarct dementia (MID), and depression in old age, as based on the DSM III criteria. A comprehensive psychological test battery was administered, to one section of the subjects. Our results indicate that EEG and Ischemic Score can differentiate patients with DAT and DVT to a satisfactory degree, whereas CT findings and psychometric assessment were apt to confirm the overall diagnosis of dementia (DAT/DVT) and depression. Patients with dementia showed memory impairment to a greater extent than depressive patients, as could be proved by a memory test (Syndrom-Kurztest). However, a dementia screening test (Information-Memory-Concentration Test) could more accurately differentiate dementia and depression. The application of a comprehensive psychometric testing procedure did not prove to be an effective diagnostic tool in the assessment of various stages of dementia. Short dementia tests and rating scales seem to be appropriate to distinguish depression from dementia, especially in cases of mild to moderate dementia. In patients with very mild and insignificant organic brain disturbances these screening methods fall short of diagnostic validity. Beyond this, there is a current need for assessment instruments in the evaluation of alterations in personality and affectivity, such as are seen in depression.

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[Intervention gerontology: remarks from the psychiatric viewpoint].

The american authors describe intervention as a preventive, especially behaviour therapeutic informed measure. It tries to influence the biographical development. Psychiatric care of need and psychiatric crisis demand a medical therapy on the up-to-date occasion or an institutional long-termed provision. Intervention programs contact themselves with the multidimensional disposition, ecological aspects, and permanent informations of concerned people and the persons of their environment.

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[Stressors as the cause of gerontopsychiatric diseases].

It is permitted to apply concepts of stress theory to clinical geropsychiatry. Biographical factors, health, illness, organic and psychosocial factors of immediate and indirect kind are very important on development and course of geropsychiatric disease. Special significance has the influence of aging. Quantity and quality of stressors must be judged as non-specificial causal factors. Treatment depends on ascertained factors. The interpretation is explained on examples of depression, dementia, and institutionalism syndrome.

Adaptation, Psychological↗

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[Gerontopsychiatry in Heidelberg: documentation].

This paper is going to investigate 108 gero-psychiatric patients with average-age of 69 +/- 10 years with overwhelming of 70- to 79-year-old persons during one annual. Data of biographic, social and disease factors and diagnostic and therapeutic methods are presented. Diagnostic main-groups are dementias and affective syndromes. At the same time existing internal disorders have a particular importance. The therapeutic concept is composed of group-methods by the side of medical and physical measures. Geropsychiatry is not dependent on "pressure of success". Nevertheless late transfer, previous history for a long time, and old age diminish possibility to improve the mental disorders.

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[Psychopathology of aging and presenility. Historical development of concept formation].

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[Sex behavior in the elderly: gerontopsychiatric aspects].

The relationship of sexuality and mental illness is not through investigated. There are few experiences. Psychiatric publications are limited and describe the deviate sexuality of demented disorders, psychosis, and neurosis. In the place of foreground of psychiatric publications are the abnormal sexuality and its criminal procedure. The paper describes the most important articles in German and English. Some references to observations in out-patient and in-patient care are following.

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[An increasing interest in the psychotherapeutic problems in middle and old age].

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[Intervention measures in social work in institutional gerontopsychiatry].

Social-worker has to follow up important functions within the diagnosis and therapy of a gerontopsychiatric station. His employment also concerns patients with serious psychiatric syndromes as well as depression, paranoia, and dementia. Social-worker completes the function of medical doctor and nurses, has to attend to patient's interests, and gives informations and advice to persons and institutions of environment. Group-therapy belonging patients and other persons to is able to prevent the regressive tendency of psychiatric persons in older age.

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[Gerontopsychiatric management in a university clinic].

The patients of the Heidelberg Section of Gerontopsychiatry in 1990 (99 persons aged between 52 and 97 years) were studied in respect to their social data, medical history, severity of illness, and extent of their need of nursing care. Of special interest was how they coped after release from the hospital. In comparison to a study performed in 1982/83, there were many more old and (especially physically) severely impaired patients. We also found an increased percentage of transferrals to nursing homes. The results are discussed with regard to gerontopsychiatric care in the Heidelberg area.

Activities of Daily Living↗