Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-28T15:07:46.813Z Has data issue: false hasContentIssue false

Older people with enduring or recurrent severe mental illness (graduates): A literature review

Published online by Cambridge University Press:  13 June 2014

Margo Wrigley
Affiliation:
Dept of Old Age Psychiatry, Mater Hospital, 61 Eccles Street, Dublin 7
Bernadette Murphy
Affiliation:
St Loman's Hospital, Palmerstown Dublin 20
Martin Farrell
Affiliation:
224 North Circular Road, Dublin 7
Brendan Cassidy
Affiliation:
Cluain Mhuire Psychiatric Services, Newtownpark Ave, Blackrock, Co Dublin
Jim Ryan
Affiliation:
Dun Laoghaire, Co Dublin, Ireland

Abstract

Objectives: To review the literature on older people with enduring or recurrent severe mental illness with an onset earlier than 65 years (graduates) and, in particular, to look at the specific features and needs of this group.

Method: A Medline literature search produced 41 relevant papers and reports on the subject.

Results: There are a substantial number of older people with severe mental illness and the number will rise in line with increased longevity. As they age these patients' psychiatric disabilities are compounded by medical and social problems. The move to community based care has largely ignored the needs of graduates who were previously cared for in psychiatric institutions.

Conclusion: There is an urgent need to plan and develop adequate services for this vulnerable group.

Type
Review
Copyright
Copyright © Cambridge University Press 2006

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

1.Arie, T, Jolley, DJ. Making services work: Organisation and style of psychogeriatric services. In The Psychiatry of Late Life ed Levy, R, Post, F.Blackwell, London 1982; 222–51.Google Scholar
2.Abdul-Hamid, W, Holloway, F, Silverman, M. Psychiatric care needs of elderly graduates – unanswered questions. Aging and Mental Health 1998; 2(3):167170.CrossRefGoogle Scholar
3.Jolley, D, Kosky, N, Holloway, F. Older people with long-standing mental illness: the graduates. Advances in Psychiatric Treatment. 2004; 10: 2736.CrossRefGoogle Scholar
4.Cohen, C, Cohen, G, Blank, Ket al.Schizophrenia and Old Adults. An Overview: Directions for Research and Policy. AMJ Geriatr Psychiatry 2000; 8: 1.CrossRefGoogle Scholar
5.Rodriguez-Ferrera, S, Vassilas, C. Older people with schrzophrenia: providing services for a neglected group. BMJ 1998; 317: 293–4.CrossRefGoogle ScholarPubMed
6.Information issues and deficits. National Council on Ageing. 2004; 67.Google Scholar
7.Gur, RE, Pelty, RG, Turetsky, BI, Gur, RC. Schizophrenia throughout life: sex differences in severity and profile of symptoms. Schizophrenia Research 1996; 21: 112.CrossRefGoogle ScholarPubMed
8.McNulty, S, Duncan, L, Semple, Met al.Care needs of elderiy people with schizophrenia. British Journal of Psychiatry 2003: 182: 241247.CrossRefGoogle ScholarPubMed
9.Harvey, PD, Bowie, CR. Late-life schizophrenia. What providers need to know. Director. 2005 Spring; 13(2): 90, 9394.Google ScholarPubMed
10.DHSS. Services for mental illness related to old age. Department of Health and Social Security Circular HM (72) 71. HMSO, London.Google Scholar
11.Roberts, J, Blow, F, Copeland, Let al.Age – Group Differences in Treatment Outcomes for Male Veterans with Severe Schizophrenia: A Three – Year Longitudinal Study. J of Ger Psych and Neurology 200; 13: 7886.CrossRefGoogle Scholar
12.Bridge, T, Cannon, H, Whytt, R. Burned – out schizophrenia: evidence for age effects on schizophrenic symptomatology. J of Gerontology 1978; 33: 835–9.CrossRefGoogle ScholarPubMed
13.Left, J. Evaluation of the closure of mental hospitals. In The closure of mental hospital ed Hall, P, Brockinton, I. Gaskel for the Royal College of Psychiatrists 1991; 2532.Google Scholar
14.Jolley, D, Kosky, N, Holloway, F. Caring for people who enter old age with enduring or relapsing mental illness (“graduates”). Council Report 110, The Royal College of Psychiatrists 2002.Google Scholar
15.Meeks, S, Carstensen, L, Stafford, Pet al.Mental health needs of the chronically mentally ill elderly. Psychology and Aging 1990; 5: 163171.CrossRefGoogle ScholarPubMed
16.Karim, S, Burns, A. Invited commentary on older people with long-standing mental illness: the graduates. Advances in Psychiatric Treatment 2004; 10: 3436.CrossRefGoogle Scholar
17.Dale, M, Burns, AGraduates”. Reviews in Clinical Gerontology 1997; 273285.Google Scholar
18.Campbell, P, Anantl, H. Graduates. In Psychiatry in the Elderly. Eds Jocoby, R, Openheimer, C. 2002.Google Scholar
19.Jones, P, Rodgers, B, Murray, Ret al.Child development risk factors for adult schizophrenia in the British 1946 birth cohort. Lancet 1994; 344:139813402.CrossRefGoogle ScholarPubMed
20.David, S, Malmberg, A, Brandt, Let al.IQ and risk for schizophrenia: a population based cohort study. Psychological Medicine 1997; 27: 1311–23.CrossRefGoogle ScholarPubMed
21.Baldessarini, R, Hegarty, J, Bird, Eet al.Meta-analysis of post-mortem studies of Alzheimer's disease like neuropathology in schizophrenia. Am J Psych 1997; 154: 861–3.Google Scholar
22.Spense, S, Hirch, S, Brooks, Det al.Prefrontal cortex activity in people with schizophrenia and control subjects. Evidence from position emission tomography for remission of “hypofrontality” with recovery from acute schizophrenia. B J Psych 1998; 172: 316–23.CrossRefGoogle Scholar
23.Duff., G. Atypical Antipsychotic Drugs and Stroke. Committee on Safety of Medicines. CEM/CMO/2004/1, 9 03 2004.Google Scholar
24.Abduul-Hamid, W, Johnson, S, Thornicroft, Get al.The Needs of Elderly Graduates Int J Geriat Psychiatry (letter) 1999; 14: 983990.Google Scholar
25.Johnstone, E, Cunningham Owens, D, Gold, Aet al.Instutionalisation and the defects of schizophrenia. BJ Psych 1981; 139: 195203.Google Scholar
26.Battels, S, Dums, A, Oxman, Tet al.Evidence – Based Practices in Geriatric Mental Health Care. Psychiatric Services 2002; 53 (11): 14191431.CrossRefGoogle Scholar
27.Cutting, JOutcome of schrzophrenia: overview. In contemporary issues in schizophrenia eds Kerr, A, Snaith, PGaskell, London 1986; 433–44.Google Scholar
28.Marshall, M. How should we measure need? Conceptand practice in the development of a standardised schedule. Philosophy, Psychology and Psychiatry 1994; 1: 2736.Google Scholar
29.Folstein, M, Folstein, S, McHugh, P. “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. J of Psychiatric Research 1975; 12: 189198.CrossRefGoogle ScholarPubMed
30.Baker, R, Hall, J. REHAB: a new assessment instrument for chronic psychiatric patients. Schizophrenia Bulletin 1988; 14: 97111.CrossRefGoogle Scholar
31.Shaw, W, Patterson, T, Semple, Set al.Use of Community Support Services by Middle Aged and Older Patients with Psychotic Disorder. Psychatric Services 2000; 51 (4): 506–512.Google Scholar
32.Auslander, L, Jeste, D. Perceptions of Problems and Needs for Service among Middle-Aged and Elderly Outpatients with Schizophrenia and Related Psychotic Disorder. Community Mental Health Journal 2002; 38 (5): 391402.CrossRefGoogle Scholar
33.Bartels, S, Miles, K, Dums, Betal.Are Nursing Homes Appropriate for Older Adults with Severe Mental Illness? Conflicting Consumer and Clinician Views and Implications for the Olmstead Decision. JAGS 2003; 51: 1571 1579.CrossRefGoogle ScholarPubMed
34.Lebowitz, B, Light, E. The aging care-givers of psychiatric patients: healthcare perspectives. Psychiatr Ann 1996; 26: 785792.CrossRefGoogle Scholar
35.Jeste, D, Alexopoulos, G, Bartels, Set al.Consensus Statement on the Upcoming Crisis in Geriatric Mental Health. Arch Gen Psychiatry 1999; 56: 848853.CrossRefGoogle ScholarPubMed
36.Granholm, E, McQuaid, J, McClure, Fet al.A randomised controlled pilot study of cognitive behavioural social skills training for older patients with schizophrenia. Schizophrenia Research 2002; 53: 167169.CrossRefGoogle ScholarPubMed
37.Linn, M, Gurel, L, Willford, Wet al.Nursing home care as an alternative to psychiatric hospitalisation. Arch Gen Psychiatry 1985; 42: 544–51.CrossRefGoogle Scholar
38.Trieman, N, Wills, W, Leff, J. Project 28: does reprovision benefit elderly long-stay mental patients? Schizophrenia Research 1996; 21: 199208.CrossRefGoogle ScholarPubMed
39.Cohler, B, Bowler, J. Schizophrenia and the life course: implications for family relations and care giving. Psychiatr Ann 1996; 26: 745756.CrossRefGoogle Scholar
40.Palmer, B, Heaton, S, Jeste, D. Older Patients with Schizophrenia. Psychiatric Services 1999; SO: 11781183.Google Scholar
41. Elderly people with mental illness: specialist services and medical training. A joint report by the Royal College of Physicians of London and the Royal College of Psychiatrists of Great Britain and Ireland 1989.Google Scholar