Do old age psychiatrists miss physical illnesses?

Tench, David; Benbow, Susan M.; Benbow, Emyr W.

doi:10.1002/gps.930071005

Cited by 12 publications

(5 citation statements)

References 21 publications

(17 reference statements)

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“…There may also be underrecording of physical problems by the CPNs. Old age psychiatrists are anxious not to miss physical illness (Tench et al, 1992), while nursing staff may have been less anxious to take this into consideration.…”

Section: Discussionmentioning

confidence: 99%

Doctors and Nurses: Referrals by General Practitioners to Different Arms of an Old Age Psychiatry Service

Ball

Payne

Lewis

1996

Int. J. Geriat. Psychiatry

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Section: Discussionmentioning

confidence: 99%

Doctors and Nurses: Referrals by General Practitioners to Different Arms of an Old Age Psychiatry Service

Ball

Payne

Lewis

1996

Int. J. Geriat. Psychiatry

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“…Less common forms of dementia are more difficult to confirm clinically, and there is considerable controversy about the diagnosis of vascular dementia (Brust, 1988;Joynt, 1988;O'Brien, 1988). The diagnosis of intercurrent non-neurological disease is also often inaccurate in old age psychiatry patients (Tench et al, 1992). The need for autopsies in old age psychiatry therefore seems to be increasing at a time when rates are, in general, in persistent decline.…”

Section: Discussionmentioning

confidence: 99%

Autopsy services for old age psychiatrists in england and wales: Can neuropathologists help?

Benbow

Reid

Benbow

1995

Int J Geriat Psychiatry

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SUMMARYWe have previously shown that many old age psychiatrists are dissatisfied with their local autopsy services. Their most common complaint was the poor quality of central nervous system examinations carried out by general histopathologists, and so we sought to determine whether neuropathologists could carry out more autopsies on old age psychiatry patients. A postal questionnaire was used, and responses indicate that neuropathologists carry out An average of 8.8 autopsies on old age psychiatry patients each year, out ofa mean total of42.2 neuropathological autopsies, and examine an average of 28.3 other brains from old age psychiatry patients, out of a mean total of 109.3 cases. In general, respondents found autopsies on psychiatric and neurological patients much more interesting than autopsies on neurosurgical and forensic cases, but did not rate psychiatric autopsies as more important than any other kind of case. Most neuropathologists would wish to examine more brains from old age psychiatry patiznts, but would require more pathologists, more technicians or more resources before doing so. Old age psychiat'iists who wish to obtain a better autopsy service may need to take the initiative.KEY WORDS-Autopsy, geriatric psychiatry, neuropathology.Some old age psychiatrists are dissatisfied with the autopsy services available to them; in particular, they are critical of examinations of the central nervous system in autopsies carried out entirely by general histopathologists. They are much more satisfied with autopsies carried out entirely by neuropathologists, or if neuropathologists examine brains removed and preserved by general histopathologists . This implies that greater participation by neuropathologists would provide an autopsy service of better quality. This study examines whether neuropathologists are able and willing to increase their involvement. METHODSQuestionnaires were sent to all neuropathologists practising at consultant or equivalent level in England and Wales. These questionnaires included questions about basic demographic details of the respondents and about their autopsy workload.Respondents were asked to rate the importance of different types of autopsy, and how interesting they found them. They were also asked whether they could increase their workloads to accommodate more cases from old age psychiatry services, whether they would be enthusiastic to do so, and to indicate which factors might limit their involvement.

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“…Clinicopathological discrepancy rates are high at all ages, and even more so in the elderly. However, we have shown previously that old age psychiatrists diagnose physical disorders in their patients with a similar degree of success to that achieved by other hospital doctors in the diagnosis of their own elderly patients (Tench et al, 1992). Increased death rates in dementia involve a range of pathologies (Jolley and Baxter, 1997).…”

Section: Dear Editormentioning

confidence: 93%