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Tijdschrift voor Psychiatrie 46 (2004) 3, 145 - 156

Review article

Personality disorders in the elderly

S.P.J. van Alphen, G.J.J.A. van Engelen, Y. Kuin, J.J.L. Derksen

background Personality disorders in the elderly constitute a relative novel topic in psychology and psychiatry.
aim To investigate whether the DSM-concept 'personality disorder' is applicable to the elderly and to find out what is known about the course, manifestation, prevalence, (test)diagnostics and treatment of personality disorders in the elderly.
method The literature was reviewed with the help of Psychinfo, Medline and PubMed (volumes 1980-2003) using the key words 'personality disorders' and 'elderly'.
results So far longitudinal research extending into later life has been done only on the anti-social personality disorder. There have been very few large-scale prevalence studies and the current prevalence figures are rather ambiguous. When the DSM-IV-TR is used, a complicating factor is the lack of age-specific criteria. The existing assessment instruments for detecting of personality disorders are not suited for the use with the elderly and no specific self-report questionnaires or interviews are available. Treatment consists of various pharmacotherapeutic interventions, several forms of psychotherapy and supportive therapy. There is a lack of effect studies on the various forms of treatment.
conclusion A provisional view is that the most suitable of treatment for elderly persons in-cludes both individual and group therapy aimed at personality adaption behaviour, possibly combined with pharmacotherapy. Future effect studies are needed to validate this view.

keywords aged, personality disorders, diagnosis, therapy