HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Clancy, E. Articles by Baldwin, R. C. PubMed Articles by Clancy, E. Articles by Baldwin, R. C.

Comparison of older people with psychosis living in the community and in care homes

University of Manchester

Robert C. Baldwin

^*Department of Old Age Psychiatry, Edale House, Manchester Mental Health and Social Care NHS Trust, Manchester Royal Infirmary, Oxford Road, Manchester M13 9BX, UK, email: robert.c.baldwin{at}manchester.ac.uk

Declaration of interest

None.

AIMS AND METHOD

To compare two groups of older people with chronic schizophrenia or delusional disorder living in the community and in care homes, along the domains of morbidity suggested by prior research. From the case-load of one old age psychiatrist, 22 individuals with chronic psychosis residing in care homes were compared to 23 living in their own homes. The measures used were: the Positive and Negative Symptom Score (PANSS; Kay et al, 1987); the Mini Mental State Examination (MMSE; Folstein et al, 1975); the Burvill Physical Illness Scale (Burvill et al, 1990); and an Activities of Daily Living Scale (IADL; Lawton et al, 1969).

RESULTS

Those in care homes had significantly higher PANSS scores (38.9 v. 21.0, P<0.01), largely accounted for by significantly more deficit symptoms (14.2 v. 5.6, P<0.01). They also had poorer cognition and significantly greater impairment in daily-life activities but their medical condition was not significantly worse. Most were seen only by a psychiatrist.

CLINICAL IMPLICATIONS

The greater morbidity and disablement of older people with chronic schizophrenia or delusional disorder living in care homes is likely to be intrinsic to the disorder but does not appear to be taken into account in current service planning or delivery.