Personality disorders in the elderly: a flagging field of inquiry.
International Journal of Geriatric Psychiatry (Impact Factor: 3.09). 12/2006; 21(11):1013-7. DOI: 10.1002/gps.1614
Article: Personality disorders and aging.[Show abstract] [Hide abstract]
ABSTRACT: Personality disorder can be defined as an enduring pattern of inner experience and behavior that markedly deviates from the expectations of the individual's culture. With aging, personality disorders may improve or worsen. Their prevalence in the elderly is slightly lower than the prevalence in young adult. Furthermore, their comorbidity and co-occurrence are the rule with an increased risk of late decompensation. Categorical approach used in the current international classifications (ICD-10 and DSM-5) is not adapted to the specificities of the elderly with consequent overrepresentation of "unspecified personality disorder". However, a pathological personality tends to complicate all interventions for somatic or psychological care in the elderly. Thus, this review describes changes in personality disorders related to aging in order to help the clinician to better identify these disorders. Indeed, recognizing a pathological personality in the elderly improves its management both in the field of mental health and in somatic disorders in which the role of personality must be evaluated. Personality and its disorders should therefore be taken into account in all geriatric practices, in particular in the context of cognitive disorders.Geriatrie et psychologie neuropsychiatrie du vieillissement 06/2014; 12(2):209-217. · 0.40 Impact Factor
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ABSTRACT: We reviewed the evidence regarding which personality traits and personality disorders remain stable into later middle and old age (age >60 years of age) and how expressions of (maladaptive) personality traits affect personality assessment among older adults. Our study was a literature review of longitudinal and cross-sectional studies of the Five Factor Model (FFM) or DSM personality disorders in old age, using PsychInfo, Psychlit, and PubMed (period 1980–2012). Combinations of the following keywords were used: personality, development, stability, five factor personality model, big 5, (borderline) personality disorder(s), aging, older adults. Of the 22 relevant articles that were found, 17 longitudinal or cross-sectional studies of the FFM mainly supported the hypothesis that personality characteristics are susceptible to change over a person’s entire lifetime. Neuroticism, Extraversion, and Openness appear to diminish as a person ages, while, conversely, Agreeableness and Conscientiousness appear to increase with age. Two longitudinal studies and three cross-sectional studies of DSM-IV personality disorders suggested there are age-related changes in the ways in which maladaptive personality traits manifest themselves. The temporal instability of personality traits in old age, both adaptive and maladaptive, affects the validity of personality assessment of older adults, especially the face validity. We recommend personality assessment measures that include only age-neutral items. Informant contributions to the personality assessment could also be helpful in improving the reliability in epidemiological research.Clinical Gerontologist 04/2014; 37(3):253-271. · 0.66 Impact Factor
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ABSTRACT: Although depression in old age is less common than depression in younger populations, it still affects more than 1 million community-living older adults. Depression in late life has been associated with reduced quality of life and increased mortality from both suicide and illness. Its causes are multifactorial but are prominently related to both biologic and social factors. Psychological factors, although less studied in elders, are also important in understanding its cause. In this article, multiple facets of late-life depression are reviewed, including its clinical presentation, epidemiology, and biopsychosocial causes.The Psychiatric clinics of North America 12/2013; 36(4):497-516. · 1.87 Impact Factor
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