Older patients referred to a consultation-liaison psychiatry clinic

Little is known about the psychiatric disorders which are associated with somatic presentations of psychological distress in older people.

A study of patients aged 65 years and over referred to an adult consultation-liaison psychiatry clinic in a general hospital.

Of 900 patients referred over a 7-year period, 45 (5%) were aged 65 years and over. The most frequent ICD-10 diagnostic category was somatoform disorder (N=30) followed by depressive disorder (N=6). The age of onset of the physical symptoms was significantly earlier in those with somatoform disorders (mean 49 years; SD 3.1 years) compared with patients with depressive disorders (mean 74 years; SD 3.1 years) (p<0.05). All diagnoses were equally associated with moderate functional impairment.

Medically unexplained physical symptoms may occur as part of a range of psychiatric disorders in older people and diagnostic groups are distinct in a number of ways. The usefulness of the ICD-10 classification of disorders in relation to these patients is considered. Implications for the delivery of old age psychiatry services are discussed.