Organic drain disease in psychogeriatric patients: Impact of symptoms and screening methods on the diagnostic process

Psychogeriatric patients are mentally affected by a heterogeneous group of diseases, traditionally classified as functional or organic brain disorders (OBDs). Here, we evaluate screening procedures with respect to revelation of underlying OBD. Fifty consecutive patients admitted to a psychogeriatric unit dedicated to late-onset psychiatric disease were included. Diagnosis at admission, symptoms, and time of onset of disease were determined blindl y by an independent, experienced psychiatrist on the basis of referral docu ments and the interview written at admission. Subsequently, consensus estab lished a clinical diagnosis (after psychiatric and neurologic evaluations) and a final diagnosis after the screening procedures (Cognistat and MMS-tes ts, electroencephalograms, computed tomography, and SPECT). Conventional cr iteria (ICD-10, ICPC) were used for diagnostic classification Only 10 of th e 50 patients were diagnosed with OBD at admission and an additional 7 pati ents following full clinical evaluations. At final diagnosis, 34 (of 46) pa tients were diagnosed with significant OED. The Cognistat test had the larg est diagnostic impact, with sensitivity/specificity values of 81%/60% for O BD.