Personality disorders in older age

Question 1

Overall prevalence

Answer 1

• 5-10% of older people exhibit features of a personality disorder
• cautiousness and obsessionality and compulsive traits become more prominent in old age
• introversion increases with age

Question 2

Old age prevalence

Answer 2

-roughly 4%

Question 3

Psychopathy

Answer 3

• said to burn out with advancing age
• criminal behaviour is rare in the elderly
• 1% of male offenders are >60

Question 4

Diagnostic criteria for personality disorders

Answer 4

-not ideal in elderly as require evidence of dysfunction from younger ages and this information is often not available in diagnosis PDs in the elderly

Question 5

Association with depression

Answer 5

• patients with PD are 4x more likely to have persistent or relapsing symptoms of depression
• avoidant, dependent and compulsive traits are most associated

Question 6

Hypochondriacal PD

Answer 6

-associated with psychotic depression

Question 7

Late paraphrenia

Answer 7

• many patients with late paraphrenia have never married or have lived alone for along time
• may suggest personality disorders are associated

Question 8

Personality changes

Answer 8

• common in organic disorders

- 2/3rds people with dementia

Question 9

Diogenes syndrome

Answer 9

• senile squalor syndrome
• syndrome of self-neglect in older people
• intervention is very difficult
• patient is often oblivious

Question 10

Syllogomania

Answer 10

• hoarding of possessions that are valueless and perceived by others as rubbish
• important in diogenes syndrome