International Psychogeriatrics

Research and Reviews

The Prevalence and Management of Dementia and Other Psychiatric Disorders in Nursing Homes 1

Barry W. Rovner a1, Pearl S. German a2, Jeremy Broadhead a3, Richard K. Morriss a4, Larry J. Brant a5, Jane Blaustein a1 and Marshal F. Folstein a1
a1 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
a2 Department of Health Policy and Management, John Hopkins University School of Public Health and Hygiene, Baltimore, Maryland
a3 Maudsley Hospital, London, England
a4 University of Leeds, Leeds, England
a5 Gerontology Research Center, Francis Scott Key Medical Center

Article author query
rovner b   [PubMed][Google Scholar] 
german p   [PubMed][Google Scholar] 
broadhead j   [PubMed][Google Scholar] 
morriss r   [PubMed][Google Scholar] 
brant l   [PubMed][Google Scholar] 
blaustein j   [PubMed][Google Scholar] 
folstein m   [PubMed][Google Scholar] 


The prevalence of psychiatric disorders among new admissions to nursing homes is unknown. Such data are needed to estimate the psychiatric needs of this population. We report the prevalence of specific psychiatric disorders in 454 consecutive new nursing home admissions who were evaluated by psychiatrists and diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised. Eighty percent had a psychiatric disorder. The commonest were dementia syndromes (67.4%) and affective disorders (10%). Also, 40% of demented patients had additional psychiatric syndromes such as delusions or depression, and these patients constituted a distinct subgroup that predicted frequent use of restraints and neuroleptics, and the greatest consumption of nursing time. These data demonstrate that the majority of nursing home residents have psychiatric disorders on admission, and that their management is often quite restrictive. Research is now needed to determine the best methods of treatment for nursing home patients with mental disorders.


1 First Place Winner of the 1989 IPA Research Awards (sponsored by Bayer AG)