Information leading to accurate diagnosis in the elderly

Psychiatric diagnosis in the elderly has been examined in order to extract the information which leads to later modification of the diagnosis. Initial diagnoses of neuroses and toxic states were least stable, 14 out of 29 changing to a different category. Information from relatives and further interviews contributed most to the modification of the initial diagnosis, though affective and neurotic syndromes were particularly susceptible to change resulting from conceptual differences, and dementia to change consequent on physical examination. It is concluded that an adequate initial interview of a patient and his next of kin will achieve a diagnosis which is correct in its major category on 95 per cent of occasions.