Psychiatric diagnoses made by the agecat system in residents of local authority homes for the elderly: Outcome and diagnostic stability after four years

Abstract

SUMMARYEighty-six residents of 12 local authority homes for the elderly were interviewed with the Geriatric Mental State (GMS) in 1985/6 after having been classed as depressed by a screening interview. The data so gathered were analysed by the computerized diagnostic program AGECAT in order to derive psychiatric diagnoses for these residents. All were traced after four years; 61 were dead. The 25 survivors were reinterviewed and given a second AGECAT diagnosis. In 1985/6 70 of the 86 examined were 'diagnostic cases' of psychiatric disorder. After four years 22 of the 25 survivors were classed as diagnostic cases. AGECAT diagnoses of organic psychosis were stable over four years within this population though the majority of subjects so diagnosed died within four years. Cases of depression had a more varied prognosis, with death, continuance as cases of depression or progression to organic psychosis being the most common outcomes. Recovery from any class of AGECAT disorder was an uncommon event.

Depression in dementia sufferers

“…Overall, 10 (6.8%) cases of depression were identified in 147 subjects. These results are surprising in view of the high overall prevalence rate of depression in these settings (Clark, 1992;Ames, 1992).…”

Diagnosis of dementia from the history and aetiology schedule

“…A computerised diagnostic system, GMS-AGECAT Dewey and Copeland, 1986) based on GMS data has also been widely used, and validated against a variety of outcomes. GMS-AGECAT has been shown to agree well with psychiatrists and other accepted measures of cognitive impairment (Kay et al, 1990), with diagnoses made in accordance with the rules of DSMIII (Ames, 1990;Copeland et al, 1990), with outcome Ames, 1992) and to predict mortality (Davidson et al, 1988).…”

Depression in older people living in residential homes

“…This result indicates a systematic and significant increase in mortality with increasing severity of depression. In one small study, the mortality rate for depressed residents reached 59% after four years (Ames, 1992).…”