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Except for dementia and depression, little is known about common mental disorders in elderly people. To estimate current, 12-month and lifetime prevalence rates of mental disorders in different European and associated countries using a standardised diagnostic interview adapted to measure the cognitive needs of elderly people. The MentDis_ICF65+ study is based on an age-stratified, random sample of 3142 older men and women (65-84 years) living in selected catchment community areas of participating countries. One in two individuals had experienced a mental disorder in their lifetime, one in three within the past year and nearly one in four currently had a mental disorder. The most prevalent disorders were anxiety disorders, followed by affective and substance-related disorders. Compared with previous studies we found substantially higher prevalence rates for most mental disorders. These findings underscore the need for improving diagnostic assessments adapted to the cognitive capacity of elderly people. There is a need to raise awareness of psychosocial problems in elderly people and to deliver high-quality mental health services to these individuals.

Affective disorders are among the most prevalent disorders in the elderly. The present study aims to examine the sociodemographic and clinical correlates of major depressive disorder (MDD) and dysthymia in different European and Associated countries using standardized interview techniques. Furthermore, service utilization for the elderly with depression is assessed. The MentDis_(I)CF65+ study is a cross-sectional survey (N = 3,142) that was conducted in six different European and Associated countries (Germany, Italy, Spain, Switzerland, England and Israel) with a subsample of n = 463 elderly with any depressive disorder. Sociodemographic and clinical correlates, such as gender, age and symptom severity, were significantly associated with MDD and dysthymia in the elderly. Only 50% of elderly with any depressive disorder were treated with psycho- or pharmacotherapy. Our findings identified sociodemographic and clinical characteristics for depression risk in the elderly and highlight the need to improve service delivery to older adults who suffer from depression.

Alcohol use disorders (AUD) in older people have been the subject of increasing interest in Europe and worldwide. However, thus far, no reliable data exist regarding the prevalence of AUD in people over the age of 65 years in Europe. To assess the current (past month), 12-month and lifetime prevalence of alcohol use, abuse and dependence in people aged 65-84 years. The MentDis_(I)CF65+ study was a representative stepwise cross-sectional survey that was conducted in six European and associated cities (Hamburg, Germany; Ferrara, Italy; London/Canterbury, England; Madrid, Spain; Geneva, Switzerland and Jerusalem, Israel). In total, 3,142 community-dwelling people aged between 65 and 84 years who lived in participating cities were assessed with an age-sensitive diagnostic interview (CIDI65+). The prevalence of lifetime alcohol use was 81% for the overall sample. The observed AUD (DSM-IV-TR) prevalence was as follows: current, 1.1%; 12-month, 5.3% and lifetime, 8.8%. Alcohol consumption and AUD were more prevalent in males, and a significant interaction between gender and city was observed; greater gender differences in the prevalence of these disorders were observed in Hamburg, London/Canterbury and Geneva in comparison to the other cities. The prevalence of lifetime alcohol consumption and 12-month AUD tended to be lower in older persons. The results highlight the appropriateness of using age-adjusted diagnostic tools (CIDI65+) to identify alcohol use and AUD in older people. Different alcohol use patterns were observed in males and females. The results seem to indicate the presence of different alcohol use patterns between northern and southern European countries. Specialized services are proposed, including brief and/or more intensive interventions framed intensive and more simple interventions framed in stepped care strategies, to improve the social and health resources available for older people across Europe.

An ageing population worldwide needs to investigate quality of life (QoL) and level of functioning (LoF) in the elderly and its associated variables. We aimed to study the relationship between Quality of Life (QoL) and Level of Functioning (LoF) in an elderly population in Europe. As part of the Ment_(D)is65+ European Project, 3142 community-dwelling adults aged 65-84 years in six countries were assessed by using the adaptation for the elderly of the Composite International Diagnostic Interview (CIDI65+) to provide psychiatric diagnosis according to the International Classification of Diseases (10th edition) (ICD-10 Classification of Mental and Behavioural Disorders). Socio-demographic and clinical interviews, and two self-report tools, the World Health Organization QoL assessment (WHO QoL BREF), to assess QoL, and the WHO Disability Assessment Schedule -II (WHODAS-II), to assess LoF, were also administered. Most subjects reported good levels of QoL (56.6%) and self-rated health (62%), with no or mild disability (58.8%). There was a linear decrease of the QoL and the LoF by increase of age. Elderly with ICD-10 mental disorder (e.g. somatoform, affective and anxiety disorders) had poorer QoL and lower LoF. There were a number of predictors of lower levels of QoL and disability, including both socio-demographic variables (e.g. male gender, increase in age, poor financial situation, retirement, reduced number of close significant others), ICD-10 psychiatric diagnosis (mainly anxiety, somatoform disorders) and presence of medical disorders (mainly heart and respiratory diseases). The study indicates that QoL and LoF were quite acceptable in European elderly people. A series of variables, including psychiatric and somatic disorders, as well as socio-demographic factor influenced in a negative way both QoL and LoF. More specific links between mental health, social and health services dedicated to this segment of the population, should be implemented in order to provide better care for elderly people with conditions impacting their QoL and functioning.

Background This study describes the study approach and field procedures of the MentDis_ICF65+ study, which aims to assess the prevalence of mental disorders in older adults. Methods An age-appropriate version of the Composite International Diagnostic Interview (CIDI65+) was developed and tested with regard to its feasibility and psychometric properties in a pre-test and pilot phase. In the cross-sectional survey an age-stratified, random sample of older adults (65–84 years) living in selected catchment areas of five European countries and Israel was recruited. Results N  = 3142 participants (mean age 73.7 years, 50.7% female) took part in face-to-face interviews. The mean response rate was 20% and varied significantly between centres, age and gender groups. Sociodemographic differences between the study centres appeared for the place of birth, number of grandchildren, close significants, retirement and self-rated financial situation. The comparison of the MentDis_ICF65+ sample with the catchment area and country population of the study centres revealed significant differences, although most of these were numerically small. Conclusions The study will generate new information on the prevalence of common mental disorders among older adults across Europe using an age-appropriate, standardized diagnostic instrument and a harmonized approach to sampling. Generalizability of the findings and a potentially limited representativeness are discussed.

Abstract Background This study describes the study approach and field procedures of the MentDis_(I)CF65+ study, which aims to assess the prevalence of mental disorders in older adults. Methods An age-appropriate version of the Composite International Diagnostic Interview (CIDI65+) was developed and tested with regard to its feasibility and psychometric properties in a pre-test and pilot phase. In the cross-sectional survey an age-stratified, random sample of older adults (65–84 years) living in selected catchment areas of five European countries and Israel was recruited. Results N = 3142 participants (mean age 73.7 years, 50.7% female) took part in face-to-face interviews. The mean response rate was 20% and varied significantly between centres, age and gender groups. Sociodemographic differences between the study centres appeared for the place of birth, number of grandchildren, close significants, retirement and self-rated financial situation. The comparison of the MentDis_(I)CF65+ sample with the catchment area and country population of the study centres revealed significant differences, although most of these were numerically small. Conclusions The study will generate new information on the prevalence of common mental disorders among older adults across Europe using an age-appropriate, standardized diagnostic instrument and a harmonized approach to sampling. Generalizability of the findings and a potentially limited representativeness are discussed.

Passive-Aggressive (Negativistic) Personality Disorder (NEGPD), listed in Appendix B of the DSM-IV, is not an officially recognized personality disorder. Its future as a discrete disorder is uncertain (Widiger, 2003). Yet, NEGPD occupies a role in some theoretical formulations of personality pathology (Millon & Davis, 1996), and many clinicians believe that passive-aggressive traits are not adequately represented by other PDs (Westen, 1997). In this study, 1158 psychiatric outpatients were assessed for Axis I and Axis II disorders. Thirty-five (3.02%) met criteria for NEGPD. Participants with NEGPD did not differ significantly from those without NEGPD on demographic variables. The internal consistency of the DSM-IV's seven NEGPD items was 0.50. Corrected item- total correlations for the 7 criteria averaged 0.27. Participants with NEGPD had higher rates of lifetime anxiety disorders, and almost 90% had an additional PD. An exploratory factor analysis suggested a two- factor solution that accounted for 43.4% of the variance. The first factor reflected the belief that life is unfair, while the second factor seemed to reflect modes of anger expression. A confirmatory factor analysis showed that the two-factor model fit the data better than a unidimensional model. We discuss implications of these results for the future of the NEGPD diagnosis.

Background An ageing population worldwide needs to investigate quality of life (QoL) and level of functioning (LoF) in the elderly and its associated variables. We aimed to study the relationship between Quality of Life (QoL) and Level of Functioning (LoF) in an elderly population in Europe. Method As part of the Ment_Dis65+ European Project, 3142 community-dwelling adults aged 65–84 years in six countries were assessed by using the adaptation for the elderly of the Composite International Diagnostic Interview (CIDI65+) to provide psychiatric diagnosis according to the International Classification of Diseases (10th edition) (ICD-10 Classification of Mental and Behavioural Disorders). Socio-demographic and clinical interviews, and two self-report tools, the World Health Organization QoL assessment (WHO QoL BREF), to assess QoL, and the WHO Disability Assessment Schedule -II (WHODAS-II), to assess LoF, were also administered. Results Most subjects reported good levels of QoL (56.6%) and self-rated health (62%), with no or mild disability (58.8%). There was a linear decrease of the QoL and the LoF by increase of age. Elderly with ICD-10 mental disorder (e.g. somatoform, affective and anxiety disorders) had poorer QoL and lower LoF. There were a number of predictors of lower levels of QoL and disability, including both socio-demographic variables (e.g. male gender, increase in age, poor financial situation, retirement, reduced number of close significant others), ICD-10 psychiatric diagnosis (mainly anxiety, somatoform disorders) and presence of medical disorders (mainly heart and respiratory diseases). Conclusions The study indicates that QoL and LoF were quite acceptable in European elderly people. A series of variables, including psychiatric and somatic disorders, as well as socio-demographic factor influenced in a negative way both QoL and LoF. More specific links between mental health, social and health services dedicated to this segment of the population, should be implemented in order to provide better care for elderly people with conditions impacting their QoL and functioning.

ABSTRACTBackgroundEmpirical data on the use of services due to mental health problems in older adults in Europe is lacking. The objective of this study is to identify factors associated with service utilization in the elderly. MethodsAs part of the MentDis_ICF65+ study, N = 3,142 people aged 65–84 living in the community in six European and associated countries were interviewed. Based on Andersen's behavioral model predisposing, enabling, and need factors were analyzed with logistic regression analyses. ResultsOverall, 7% of elderly and 11% of those with a mental disorder had used a service due to mental health problems in the last 12 months. Factors significantly associated with underuse were male sex, lower education, living in the London catchment area, higher functional impairment and more comorbid mental disorders. The most frequently reported barrier to service use was personal beliefs, e.g. “I can deal with my problem on my own” (90%). ConclusionUnderutilization of mental health services among older people in the European community is common and interventions are needed to achieve an adequate use of services.

Alcohol use disorders (AUD) in older people have been the subject of increasing interest in Europe and worldwide. However, thus far, no reliable data exist regarding the prevalence of AUD in people over the age of 65 years in Europe. To assess the current (past month), 12-month and lifetime prevalence of alcohol use, abuse and dependence in people aged 65-84 years. The MentDis_ICF65+ study was a representative stepwise cross-sectional survey that was conducted in six European and associated cities (Hamburg, Germany; Ferrara, Italy; London/Canterbury, England; Madrid, Spain; Geneva, Switzerland and Jerusalem, Israel). In total, 3,142 community-dwelling people aged between 65 and 84 years who lived in participating cities were assessed with an age-sensitive diagnostic interview (CIDI65+). The prevalence of lifetime alcohol use was 81% for the overall sample. The observed AUD (DSM-IV-TR) prevalence was as follows: current, 1.1%; 12-month, 5.3% and lifetime, 8.8%. Alcohol consumption and AUD were more prevalent in males, and a significant interaction between gender and city was observed; greater gender differences in the prevalence of these disorders were observed in Hamburg, London/Canterbury and Geneva in comparison to the other cities. The prevalence of lifetime alcohol consumption and 12-month AUD tended to be lower in older persons. The results highlight the appropriateness of using age-adjusted diagnostic tools (CIDI65+) to identify alcohol use and AUD in older people. Different alcohol use patterns were observed in males and females. The results seem to indicate the presence of different alcohol use patterns between northern and southern European countries. Specialized services are proposed, including brief and/or more intensive interventions framed intensive and more simple interventions framed in stepped care strategies, to improve the social and health resources available for older people across Europe.