Theme Mental disorders of advanced in years and old age icon

Theme Mental disorders of advanced in years and old age




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Theme 8. Mental disorders of advanced in years and old age.




1. What feature of the treatment of psychiatric disorders among the elderly is characteristic?

a) treatment in hospital is usually preferable to treatment at home

b) large drug dosages is needed

c) social measures are less important then in younger adults

d) there is a need to involve and support families

e) nothing listed


2. What is the characteristic of delirium among the elderly?

a) mortality is high then in younger adults

b) may be misdiagnosed as dementia

c) many of the causes of delirium threaten life

d) all listed

e) nothing listed


3. Which of the listed groups of dementia among the elderly is caused by seri­ous atherosclerosis and hypertensive disease?

a) dementia of the Alzheimer type

b) vascular dementia

c) multi-infarct dementia

d) psychogenic dementia

e) dementia due to vitamin deficiency


4. Clinical features of Alzheimer's disease include all listed, except:

a) poor memory

b) progressive disorientation

c) mood change

d) more frequent among men

e) dysphasia


5. What is the characteristic of a paranoid state among the elderly?

a) persecutory delusions

b) cognitive impairment

c) evidence of paranoid personality disorder

d) visual hallucinations

e) profound mood disturbance


6. What is the characteristic of depressive disorders among the elderly?

a) symptoms of agitation may be mistaken for an anxiety disorder

b) may be misdiagnosed as dementia

c) apparent hypochondriacal symptoms

d) all listed

e) nothing listed


7. Which medicine is used as hypnotics for the elderly?

a) Aminazine

b) Chlormethiazole

c) Amitriptyline

d) Sibazon

e) all listed

8 There are all listed groups of dementia in this age group, except:

a) dementia of the Alzheimer type

b) vascular dementia

c) multi-infarct dementia

d) psychogenic dementia

e) dementia due to vitamin deficiency


9. Which of the listed groups of dementia among the elderly is caused by vascular occlusions in the brain?

a) dementia of the Alzheimer type

b) vascular dementia

c) multi-infarct dementia

d) psychogenic dementia

e) dementia due to vitamin deficiency


10. Clinical features of multi-infarct dementia include all listed, except:

a) dyspraxia

b) personality change

c) seizures

d) episodes of confusion

e) stepwise progression


Clinical task 1.

The patient K.,73 years old, is polite in communication with others. Greets the doctor several times a day, whenever he meets him. Can't name the date, month or year. Says: "I've come here today" (really the patient has spent 3 months at the hospital). In a few minutes after the interview with his psychiatrist, completely forgot the content of their con­versation. The patient remembers well most of the events that oc­curred when he was young, can tell the dates if important historical events, but forgets recent events. The professional skills are intact, but can’t count up 12+5.

1. What symptoms does the patient have?

2. What psychopathological syndromes does the patient have?

3. What disease can you think of?

4. Prescribe treatment to the patient.


Clinical task 2.

The patient A., 58 y.o., complains that he was unjustly transferred to a lower posi­tion at work with smaller salary. He thinks that this happened because his boss overheard his conversation with his colleague, in which the patient criticised the boss. In his new position he behaves extremely carefully, in the actions of his colleagues he "sees" bad attitude towards him. The patient is full of thoughts about "persecution" and "overhearing of conversations." Thinks that in this way the administration is getting rid of disagreeable employees.

1. What symptoms does the patient have?

2. What psychopathological syndromes does the patient have?

3. What disease can you think of?

4. Prescribe treatment to the patient.


Clinical task 3.

The patient S., 56y.o., is excited and restless, incessantly walks around the room, wrings her hands, weeps and groans. There is an expression of fear on her face. Asks the people around her to save her family, which is sure to be in great danger. Promises to give the people much money for rescuing her rela­tions. The personnel can't dissuade her: the patient stays extremely anxious. Couldn't sleep for two nights, and hasn't eaten any food for three days, say­ing, "How can I eat, when my dear ones are dying?" Tried to commit sui­cide.

1. What symptoms does the patient have?

2. What psychopathological syndromes does the patient have?

3. What disease can you think of?

4. Prescribe treatment to the patient.


Clinical task 4.

Patient P., female, 57 years old was brought to the mental health serv­ice by the police because she couldn't find her way home. Her speech is scrambled. Told the police officer who found her wondering in the street, that she lived with her two sis­ters, told him her address, first and family name. The police found out that the name she gave was her maiden's name, and she had really had the ad­dress she gave, but it was 40 years ago. She had her own family, a son and a daughter, but she didn't remember that they were grown-ups, and thought that they were small children. Couldn't remember what had happened to her in the morning, before she left home. She writes illegibly and can’t to calculate.

1. What symptoms does the patient have?

2. What psychopathological syndromes does the patient have?

3. What disease can you think of?

4. Prescribe treatment to the patient.

List of recommended literature

Basic literature.

  1. Concise Oxford Textbook of Psychiatry. M. Gelder, D. Gath, R.Mayou. – Oxford; New York; Tokyo; Oxford University Press, 2007. – 953 p.

  2. Modern Synopsis of Psychiatry. A.M. Freedman, H.I. Kaplan, B.J. Sadock. – USA, 1982. – 433 p.

  3. Psychiatric Dictionary / 5th ed. R.J. Campbell. – Oxford; New York; Oxford University Press, – 1981. – 693 p.

  4. Psychopatology and addictive Disorders / Ed. By Meyer. - New York; London, 1986. – 283 p.

  5. Psychiatry: course of lecture /Ed.by V.S. Bitensky. – Odessa, 2005. – 336 p.

  6. Zimbardo Ph.G. Psychology and Life. - USA, 19991. – 189 p.


Additional literature.


  1. Brundtland G.H. Mental health in the 21st century // Bulletin of the World Helth Organization. – 2000. - №87. – Р. 411.

  2. Desjarlais R., Eisenberg L., Good B. et al. World Mental Health: Problems and Priorities in Low-Income Countries. – New York: Oxford University Press, 1995. – 144 p.

  3. Marsella A., Kleinman A., Good B. Cross-cultural studies of depressive disorders. An overview. Culture and depression. – Berkley: University of California Press, 1985. – 213 p.

  4. Mulrow C.D., Williams J.W. Jr., Trivedi M., et al. Treatment of depression: newer pharmacotherapies. Rockville, MD: Agency for Health Care Policy and Research, 1999. – 253 р.

  5. Murray C.J.L., Lopez A.D. The global burden of disease: a comprehensive assessment of mortality and disability from disease, injuries and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard University Press, 1996. – 68 p.

  6. Kielholz P. Masked Depression. — Berne, 1973. – 97 p.

  7. Lopez-Ibor J. J. The Present Status of Psychotropic Drugs / Ed. by A. Cerletti, F. J. Bove. - New York, 1999. - 519 p

  8. Preskorn, S.H. Outpatient management of depression: A guide for the Primary-care practitioner/ S.H. Preskorn. - Wichita; Kansas: Professional Communications,Inc., 1994. - 147 p.

  9. Ustun T.B., Sartorius N. Mental Illness in General Health Care. An International Study. – Chichester: John Willey @ Sons Ltd, 1995. – 336 p.

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