Psychiatry and the elderly in the Middle East: a report from Iran

One of the more firmly established generalizations in mental health concerns the positive correlation found between aging on the one hand and levels of psychiatric distress and utilization of mental health services on the other. It is also generally believed that the young, being more resilient and healthier, possess a greater capacity to cope with psychiatric stress than the elderly. The causal inferences are often unavoidable. Since cross-cultural studies can examine naturally occurring differences in exogenous factors, they may help clarify some of the causal connections. This paper presents utilization rates as well as the results of psychiatric tests on older and younger populations of psychiatric patients and addicts in Iran. The psychiatric population includes both inpatients and outpatients from hospitals and clinics in Tehran, and the provinces. The addicts' population includes a nationwide sample of registered addicts as well as illicit addicts from Tehran and other provinces. Psychiatric profiles are constructed from Symptom-Checklist-90 (SCL-90) questionnaire translated and adapted for use in Iran. For each individual, nine primary symptom distress levels together with three global indices are obtained. Primary comparison is made across age variable with fifty-five years and over age group versus those below fifty-five years of age. Secondary comparisons include psychiatric versus addicts, inpatients versus outpatients, male versus female, as well as comparisons across other socio-economic variables. Findings are discussed in the light of prevalent socio-cultural factors.