Constitution and the Psychiatry of Old Age

¹ Consultant Psychiatrist, Springfield Hospital, S.W.17
² Physician, The Bethlem Royal Hospital and The Maudsley Hospital, S.E.5
³ Lecturer in Psychological Statistics, Institute of Psychiatry, The Maudsley Hospital, S.E.5

In a survey of 158 psychiatric patients over the age of 60 (106 women and 52 men), the constitution was studied by various methods. It was found that anthropometry appeared to provide useful data, and could be used (besides ancillary methods of estimating the constitution) to compare subgroups of the series.

The patients were classified by diagnosis (Dementias, Depressives with and without organic features, Schizophrenics with and without organic features and Others) and these categories were correlated with the physical measurements. Height and biacromial diameter correlated positively (in women only) with dementia and cases with organic features. These also were the categories with the highest mean age.

The cases were divided later into those who had first become ill after the age of 60 years, and those first ill before, and the two groups contrasted. The differences found by Roth and Kay (and other workers) with respect to pathogenic factors and outcome could not be confirmed in this sample. However, the late onset depressives and schizophrenics appeared to show fewer neurotic features in their premorbid personality than those of early onset. In women, a high neurosis rating correlated positively with height.

The outcome in men was favourably affected by low weight and skinfold measurements on admission and those who made best progress tended also to gain most weight. In depressives, organic features were correlated with a bad outcome, especially after 6 months; these same patients, however, were of relatively heterogeneous premorbid personality, suggesting that organic processes may precipitate depression in a variety of constitutions.