The prevalence of psychiatric illness among continuing‐care patients under the care of departments of geriatric medicine

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Abstract
Between 1983 and 1987, 568 patients in three centres, who were under the care of consultant physicians with a special interest in elderly people, were referred to a randomized controlled trial as part of the evaluation of the three experimental NHS nursing homes. All patients referred to the trial were defined by the referring consultant as ‘long‐stay’ or ‘continuing‐care’ patients. The mental state of patients was assessed as part of the baseline assessments undertaken at entry to the trial. Two methods of assessment were used. First, the presence of organic psychiatric disorders and of affective disorders and psychoneuroses was assessed using the Survey Psychiatric Assessment Schedule. Second, the presence of ‘confusion’ was estimated using the the modified Crichton Royal Behavioural Rating Scale. The prevalence of organic psychiatric conditions was found to be 72% and of affective disorders and psychoneuroses 40%. This substantial proportion of people with psychiatric illness has major implications for the training of both medical and nursing staff working in non‐psychiatric hospitals.