Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Introduction – A personal note
- Acknowledgement
- Part 1 Classification
- Part 2 General epidemiology
- Part 3 Neuroses
- Part 4 Affective disorders
- Part 5 Psychosexual disorders
- Part 6 Substance use and abuse
- Part 7 Schizophrenia and related psychoses
- Part 8 Psychological, biological and medical issues
- 20 A developmental psychology of old age
- 21 The biology of functional psychiatric disorders
- 22 Brain imaging in functional psychiatric disorders of the elderly
- 23 Medical co-morbidity: presentation in a general hospital setting
- 24 Psychiatric aspects of cerebro-vascular disease
- Part 9 Treatment methods
- Part 10 Conclusion
- Index
21 - The biology of functional psychiatric disorders
from Part 8 - Psychological, biological and medical issues
Published online by Cambridge University Press: 13 November 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Introduction – A personal note
- Acknowledgement
- Part 1 Classification
- Part 2 General epidemiology
- Part 3 Neuroses
- Part 4 Affective disorders
- Part 5 Psychosexual disorders
- Part 6 Substance use and abuse
- Part 7 Schizophrenia and related psychoses
- Part 8 Psychological, biological and medical issues
- 20 A developmental psychology of old age
- 21 The biology of functional psychiatric disorders
- 22 Brain imaging in functional psychiatric disorders of the elderly
- 23 Medical co-morbidity: presentation in a general hospital setting
- 24 Psychiatric aspects of cerebro-vascular disease
- Part 9 Treatment methods
- Part 10 Conclusion
- Index
Summary
Introduction
Why study the biological aspects of psychiatric illness in elderly people? The question leads to three others.
(i) Are there features specific to psychiatric illness in elderly patients?
(ii) Are the biological features in young patients also present in elderly patients?
(iii) Can evidence obtained from such study help determine whether aging itself is a factor in the late onset of psychiatric illness?
Answers to the first two questions might help show whether late onset disorders are materially different from early onset disorders. Some still believe this to be the case with depression (Teicher et al., 1988) and it remains an issue in relation to the para-/schizo-phrenias (Almeida et al., 1992). The last question is perhaps the most interesting but difficult to examine.
In the case of affective disorders, the notion that the process of physical aging acts as a risk factor has long been held (Burton, 1652; Maudsley, 1879; Charcot, 1881). In modern times, Post (1968) eloquently laid out the argument. Given that the genetic contribution was thought to diminish with increasing age of first onset and that there was little evidence to suggest personality weakness was of any importance, he wrote:
Why, then, is it that some people respond with depressive reactions… A deceptively simple answer might be that in some individuals there occur changes due to aging which make them particularly liable to succumb to stresses in a depressive fashion.
Post dismissed the possibility of endocrinological disorder and favored structural changes of the brain, which was reasonable given the state of knowledge at the time.
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- Functional Psychiatric Disorders of the Elderly , pp. 355 - 376Publisher: Cambridge University PressPrint publication year: 1994