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Psychiatric Diagnosis and Uncooperative Behavior in Nursing Homes

Department of Psychiatry and Human Behavior (Dr Rovner), Thomas Jefferson University/Jefferson Medical College, Wills Eye Hospital—Geriatric Psychiatry Unit, Philadelphia, PA, Johns Hopkins University School of Medicine (Ms Steele), the Department of Health Policy and Management (Dr German and Ms Clark), Johns Hopkins University School of Hygiene and Public Health, and the Department of Psychiatry and Behavioral Sciences (Dr Folstein), Johns Hopkins School of Medicine, Baltimore, MD.

Cynthia D. Steele, RN, MPH

Department of Psychiatry and Human Behavior (Dr Rovner), Thomas Jefferson University/Jefferson Medical College, Wills Eye Hospital—Geriatric Psychiatry Unit, Philadelphia, PA, Johns Hopkins University School of Medicine (Ms Steele), the Department of Health Policy and Management (Dr German and Ms Clark), Johns Hopkins University School of Hygiene and Public Health, and the Department of Psychiatry and Behavioral Sciences (Dr Folstein), Johns Hopkins School of Medicine, Baltimore, MD.

Pearl German, ScD

Department of Psychiatry and Human Behavior (Dr Rovner), Thomas Jefferson University/Jefferson Medical College, Wills Eye Hospital—Geriatric Psychiatry Unit, Philadelphia, PA, Johns Hopkins University School of Medicine (Ms Steele), the Department of Health Policy and Management (Dr German and Ms Clark), Johns Hopkins University School of Hygiene and Public Health, and the Department of Psychiatry and Behavioral Sciences (Dr Folstein), Johns Hopkins School of Medicine, Baltimore, MD.

Rebecca Clark, BA

Department of Psychiatry and Human Behavior (Dr Rovner), Thomas Jefferson University/Jefferson Medical College, Wills Eye Hospital—Geriatric Psychiatry Unit, Philadelphia, PA, Johns Hopkins University School of Medicine (Ms Steele), the Department of Health Policy and Management (Dr German and Ms Clark), Johns Hopkins University School of Hygiene and Public Health, and the Department of Psychiatry and Behavioral Sciences (Dr Folstein), Johns Hopkins School of Medicine, Baltimore, MD.

Marshall F. Folstein, MD

Department of Psychiatry and Human Behavior (Dr Rovner), Thomas Jefferson University/Jefferson Medical College, Wills Eye Hospital—Geriatric Psychiatry Unit, Philadelphia, PA, Johns Hopkins University School of Medicine (Ms Steele), the Department of Health Policy and Management (Dr German and Ms Clark), Johns Hopkins University School of Hygiene and Public Health, and the Department of Psychiatry and Behavioral Sciences (Dr Folstein), Johns Hopkins School of Medicine, Baltimore, MD.

The prevalence of psychiatric disorders and behavioral disturbances in nursing homes is high, but the relationship between the two is unknown. We studied 454 new admissions who were diagnosed by research psychiatrists using DSM-III-R criteria and compared patients who nursing staff designated as cooperative or uncooperative by psychiatric diagnosis and use of restraints and neuroleptics. Uncooperative patients (n = 79; 17.4%) had a variety of psychiatric disorders (total, 87.3%) but particularly had dementia syndromes complicated by delusions, depression, or delirium (44.3%). Uncooperative patients were more frequently restrained and prescribed neuroleptics. Determining the origins of behavior disorders in patients with psychiatric disorders in nursing homes may reduce behavior disturbances. (J Geriatr Psychiatry Neurol 1992;5:102–105).

Journal of Geriatric Psychiatry and Neurology, Vol. 5, No. 2, 102-105 (1992)
DOI: 10.1177/002383099200500207


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