[Psychiatric disorders in non demented elderly people]

Psychogeriatrics is a rapidly growing field. In France, the focus is currently on targeted education and specific management. Psychiatric disorders may be atypical in the elderly, and may also be difficult to distinguish from the effects of aging or somatic disorders. The principal disorders observed in old age are depression, late delusion, anxiety disorder, hysteria, delirium and mania. Depression has specific features, depressive equivalents, particular risk factors, and a categorical and dimensional therapeutic approach. Diagnosis and screening must be improved Late delusion is organized around a notion of injury, and is an active attempt to deal with isolation, depression and anxiety. The term "very late-onset schizophrenia-like psychosis" has been proposed. Anxiety also has specific features in the elderly and is intimately related to depression. If left untreated, the consequences can be severe. Hysteria is pathoplastic with time, age and educational status. Pseudocognitive conversions are starting to be seen in old age. Delirium is very frequent in the elderly; it is often multifactorial, but psychosocial factors must not be underestimated. Mania can also be provoked by somatic disease, and mixed syndromes are far from rare. Dementia can be approached from its psychopathological dimension, particularly in terms of psychosocial risk factors and protective factors relating to the individual's biography and personality. Thus, psychogeriatrics is an integrated medical discipline in which psychiatric disorders are approached through specific clinical management, oriented research and structured training.