[Diagnosis and significance of psychiatric disorders in physically ill geriatric patients]

Psychic disorders were studied with a naturalistic design in 125 consecutive patients of a medical-geriatric department in a general hospital. Based on the clinical examination and the values of the Mini-Mental-State-Examination (2), 51 patients were classified as unable for diagnostic procedures concerning psychic state. The other 74 patients underwent these diagnostic procedures including clinical investigation and three screening-scales (Geriatric Depression Scale (11); Hospital Anxiety and Depression-Scale (4)). If these examinations led to the suspicion that a patient suffered from a psychic disorder, an interview was performed by a psychotherapist with experience in gerontopsychosomatic treatment and information was collected from the medical and nursing staff. Dementia was detected or excluded by neuropsychological tests. Psychic disorders were found in 41 patients, mostly adaptation disorders and depressions. In more than half of the patients, the disorder was estimated to be relevant for the whole hospital therapy. The screening instruments turned out to be reliable, so they can be recommended for further use. Difficult to answer remains the question, how the treatment of the psychic disorders--in our sample necessary for each 5th to 6th patient--can be implemented in a medical-geriatric department.