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Chapter 9. The Psychiatric Interview of Older Adults

Dan G. Blazer, M.D., Ph.D.
DOI: 10.1176/appi.books.9781585623754.389648

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Excerpt

The foundation of the diagnostic workup of the older adult experiencing a psychiatric disorder is the diagnostic interview. Unfortunately, in this age of increasing technology in the laboratory and standardization of interview techniques, the art of the clinical interview has suffered. Also, time pressures limit clinicians' ability to perform a thorough diagnostic workup. Nevertheless, such a workup will save valuable time over the course of an older adult's illness. In fact, there is no substitute, even with modern technologies, for a thorough initial assessment of the older adult. In this chapter, I review the core of the psychiatric interview, including history taking, assessment of the family, and the mental status examination; describe structured interview schedules and rating scales that are of value in the assessment of older adults; and outline techniques for communicating effectively with older adults.

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Table Reference Number
Table 9–1. Diagnostic workup of the elderly patient

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Sample questions:
1.
In gathering information from elderly patients concerning their present illness, you should assess their function and change in function. Two important parameters for this type of assessment are not normally included in the assessment of physical and psychiatric illness in younger adults. One of these parameters is social functioning. What is the other?
2.
A primary goal of the clinician as an advocate for the psychiatrically ill older adult is to facilitate family support. Areas that are important to evaluate include all of the following except
3.
Testing the memory of an older patient is an important component of the mental status examination. Asking the older person to repeat a word, phrase, or series of numbers assesses which component of memory?
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