Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-29T13:47:31.255Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence of psychotic symptoms among older adults in an Asian population

Published online by Cambridge University Press:  14 March 2016

Mythily Subramaniam ,
Edimansyah Abdin ,
Janhavi Vaingankar ,
Louisa Picco ,
Shazana Shahwan ,
Anitha Jeyagurunathan ,
Yunjue Zhang ,
Swapna Verma  and
Siow Ann Chong
Mythily Subramaniam*
Affiliation:
Research Division, Institute of Mental Health, Singapore
Edimansyah Abdin
Affiliation:
Research Division, Institute of Mental Health, Singapore
Janhavi Vaingankar
Affiliation:
Research Division, Institute of Mental Health, Singapore
Louisa Picco
Affiliation:
Research Division, Institute of Mental Health, Singapore
Shazana Shahwan
Affiliation:
Research Division, Institute of Mental Health, Singapore
Anitha Jeyagurunathan
Affiliation:
Research Division, Institute of Mental Health, Singapore
Yunjue Zhang
Affiliation:
Research Division, Institute of Mental Health, Singapore
Swapna Verma
Affiliation:
Department of Early Psychosis Intervention, Institute of Mental Health, Singapore
Siow Ann Chong
Affiliation:
Research Division, Institute of Mental Health, Singapore
*
Correspondence should be addressed to: Mythily Subramaniam, Director, Research Division Institute of Mental Health Buangkok Green Medical Park, 10 Buangkok View, 539747Singapore. Phone: +65–6389 3633; Fax: +65–6343 7962. Email: Mythily@imh.com.sg.
Get access

Abstract

Background:

Psychotic symptoms are common among older adults and are seen in a wide range of conditions. Most studies examining the prevalence and correlates of psychotic symptoms among older adults have been conducted in Western populations. To address this gap the current study was undertaken to establish the prevalence and correlates of psychotic symptoms and paranoid ideation within a community sample of older adults without dementia in an Asian population.

Methods:

The Well-being of the Singapore Elderly (WiSE) study was a comprehensive single phase, cross-sectional survey. All respondents were assessed using the Geriatric Mental State examination (GMS). Specific questions of the GMS were then used to establish the prevalence of hallucinations and persecutory delusions.

Results:

A total of 2,565 respondents completed the study giving a response rate of 65.6%. The prevalence of any psychotic symptoms in this population of older adults was 5.2%. The odds of hallucinations and any psychotic symptoms were significantly higher among those of Malay ethnicity, and those who had no formal education. Older adults aged 75–84 years were significantly associated with lower odds of having hallucinations (vs. older adult aged 60–74 years), while homemaker status was significantly associated with lower odds of having any psychotic symptoms.

Conclusions:

The prevalence of psychotic symptoms among older Asian adults without dementia was higher than that reported from Western countries. Psychotic symptoms were associated with Malay ethnicity, poor cognitive performance and fewer years of schooling, visual and hearing impairment as well as depression and irritability.

Keywords

psychosishallucinationsdelusionsgeriatric mental state examinationAsian
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 7 , July 2016 , pp. 1211 - 1220
Copyright
Copyright © International Psychogeriatric Association 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Beecham, J. and Knapp, M. (1992). Costing psychiatric interventions. In Thornicroft, G., Brewin, C. R. and Wing, J. (eds.), Measuring Mental Health Needs (pp. 163–183). London: Gaskell.Google Scholar
Blazer, D. G., Hays, J. C. and Salive, M. E. (1996). Factors associated with paranoid symptoms in a community sample of older adults. Gerontologist, 36, 70–75.CrossRefGoogle Scholar
Chang, J. S. et al. (2015). Differences in the internal structure of hallucinatory experiences between clinical and nonclinical populations. Psychiatry Research, 226, 204–2 vvvvc10.CrossRefGoogle ScholarPubMed
Cohen, C. I., Magai, C., Yaffee, R. and Walcott-Brown, L. (2004). Racial differences in paranoid ideation and psychoses in an older urban population. American Journal of Psychiatry, 161, 864–871.Google Scholar
Cooper, A. F. and Curry, A. R. (1976). The pathology of deafness in the paranoid and affective psychoses of later life. Journal of Psychosomatic Research, 20, 97–105.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Kelleher, M. J. and Kellett, J. M. (1976). A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the geriatric mental state schedule. Development and reliability. Psychological Medicine, 6, 439–449.Google Scholar
Gilley, D. W., Bienias, J. L., Wilson, R. S., Bennett, D. A., Beck, T. L. and Evans, D. A. (2004). Influence of behavioral symptoms on rates of institutionalization for persons with Alzheimer's disease. Psychological Medicine, 34, 1129–1135.Google Scholar
Gilley, D. W., Wilson, R. S., Becket, L. A. and Evan, D. A. (1997). Psychotic symptoms and physically aggressive behaviour in Alzheimer's disease. Journal of the American Geriatrics Society, 45, 1074–1079.CrossRefGoogle ScholarPubMed
Hall, K. S. et al. (1993). The development of a dementia screening interview in two distinct languages. International Journal of Methods in Psychiatric Research, 3, 1–28.Google Scholar
Haque, A. (2008). Culture-bound syndromes and healing practices in Malaysia. Mental Health. Religion & Culture, 11, 685–696.CrossRefGoogle Scholar
Henderson, A. S. et al. (1998). Psychotic symptoms in the elderly: a prospective study in a population sample. International Journal of Geriatric Psychiatry, 13, 484–492.3.0.CO;2-7>CrossRefGoogle Scholar
Henderson, A. S. and Kay, D.W. K. (1997). The epidemiology of functional psychoses of late onset. European Archives of Psychiatry Clinical Neuroscience, 247, 176–189.CrossRefGoogle ScholarPubMed
Johns, L. C. (2005). Hallucinations in the general population. Current Psychiatry Reports, 7, 162–7.CrossRefGoogle ScholarPubMed
Karim, S. and Byrne, E. J. (2005). Treatment of psychosis in elderly people. Advance in Psychiatric Treatment, 11, 286–296.Google Scholar
Kish, L. (1965). Survey Sampling. New York: John Wiley & Sons, Inc. Google Scholar
Leroi, I., Voulgari, A., Breitner, J. C. and Lyketsos, C. G. (2003). The epidemiology of psychosis in dementia. American Journal of Geriatric Psychiatry, 11, 83–91.Google Scholar
Livingston, G., Kitchen, G., Manela, M., Katona, C. and Copeland, J. (2001). Persecutory symptoms and perceptual disturbance in a community sample of older people: the Islington study. International Journal of Geriatric Psychiatry, 16, 462–468.Google Scholar
Mourik, J. C., Rosso, S. M., Niermeijer, M. F., Duivenvoorden, H. J., Van Swieten, J. C. and Tibben, A. (2004). Frontotemporal dementia: behavioral symptoms and caregiver distress. Dementia Geriatric Cognitive Disorder, 18, 299–306.Google Scholar
Ng, L. O., Wee, L. H., Lee, J. K., Johari, M. Z., Hassan Nudin, S. S. A. and Omar, B. (2014). Developing a Malaysian psychotic symptom screening inventory: an exploratory study. International Journal of Culture and Mental Health, 7, 386–397 Google Scholar
Ng, T., Leong, T., Chiam, P. and Kua, E. (2010). Ethnic variations in dementia: the contributions of cardiovascular, psychosocial and neuropsychological factors. Dementia Geriatric Cognitive Disorder, 29, 131–138.Google Scholar
Östling, S. et al. (2013). Paranoid symptoms and hallucinations among the older people in Western Europe. International Journal of Geriatric Psychiatry, 28, 573–579.Google Scholar
Ostling, S., Gustafson, D. and Waern, M. (2009). Psychotic and behavioural symptoms in a population-based sample of the very elderly subjects. Acta Psychiatrica Scandinavica, 120, 147–152.Google Scholar
Ostling, S., Palsson, S. P. and Skoog, I. (2007). The incidence of first-onset psychotic symptoms and paranoid ideation in a representative population sample followed from age 70–90 years. Relation to mortality and later development of dementia. International Journal of Geriatric Psychiatry, 22, 520–528.Google Scholar
Ostling, S. and Skoog, I. (2002). Psychotic symptoms and paranoid ideation in a nondemented population-based sample of the very old. Archives of General Psychiatry, 59, 53–59.Google Scholar
Prince, M. et al. (2007). The protocols for the 10/66 dementia research group population-based research programme. BMC Public Health, 7, 165.Google Scholar
Rehm, J., Ustun, T. B. and Saxena, S. (2000). On the development and psychometric testing of the WHO screening instrument to assess disablement in the general population. International Journal of Methods in Psychiatric Research, 8, 110–122.Google Scholar
Scarmeas, N. et al. (2005). Delusions and hallucinations are associated with worse outcome in Alzheimer disease. Archives of Neurology, 62, 1601–1608.Google Scholar
Shaji, K. S., Smitha, K., Lal, P. and Prince, M. J. (2003). Caregivers of patients with Alzheimer's disease: a qualitative study from the Indian 10/66 dementia research network. International Journal of Geriatric Psychiatry, 18, 1–6.Google Scholar
Sigström, R. et al. (2009). The prevalence of psychotic symptoms and paranoid ideation in non-demented population samples aged 70–82 years. International Journal of Geriatric Psychiatry, 24, 1413–1419.Google Scholar
Soares, W. B., Ribeiz, S. R., Bassitt, D. P., De Oliveira, M. C. and Bottino, C. M. (2015). Psychotic symptoms in older people without dementia from a Brazilian community-based sample. International Journal of Geriatric Psychiatry, 30, 437–445.Google Scholar
Statistics Singapore. (2014). Population Trends. Available online on http://www.singstat.gov.sg/docs/default-source/default-document-library/publications/publications_and_papers/population_and_population_structure/population2014.pdf; last accessed 26 April 2015.Google Scholar
Stefanis, N., Thewissen, V., Bakoula, C., van Os, J. and Myin-Germeys, I. (2006). Hearing impairment and psychosis: a replication in a cohort of young adults. Schizophrenia Research, 85, 266–272.Google Scholar
Subramaniam, M. et al. (2015). Prevalence of dementia in people aged 60 years and above: results from the WiSE study. Journal of Alzheimer's Disease, 45, 1127–1138.CrossRefGoogle ScholarPubMed
Subramaniam, M., Abdin, E., Vaingankar, J. A., Verma, S. and Chong, S. A. (2014). Latent structure of psychosis in the general population: results from the Singapore mental health study. Psychological Medicine, 44, 51–60.Google Scholar
Tan, L. L. and Seng, K. H. (2012) First presentation psychosis among the elderly in Singapore. Singapore Medical Journal, 53, 463–7.Google Scholar
van Os, J., Howard, R., Takei, N. and Murray, R. (1995). Increasing age is a risk factor for psychosis in the elderly. Social Psychiatry Psychiatric Epidemiology, 30, 161–164.CrossRefGoogle ScholarPubMed
Welsh, K. A. et al. (1994). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part V. A normative study of the neuropsychological battery. Neurology, 44, 609–614.Google Scholar
Zayas, E. M. and Grossberg, G. T. (1998). The treatment of psychosis in late life. Journal of Clinical Psychiatry, 59 (Suppl. 1), 5–12.Google Scholar