Psychiatric morbidity in a neurology-based memory clinic: The effect of systematic psychiatric evaluation

Objectives: To estimate the prevalence of psychiatric morbidity and the effect of systematic psychiatric evaluation in patients referred to a memory clinic in a neurological setting. Design: Descriptive case-series study in consecutive referrals to a memory clinic. Setting: An outpatient multidisciplinary memory clinic in a neurological setting. Participants: An index group of 100 consecutive patients (aged 60-89) referred for diagnostic evaluation of cognitive symptoms during a period of 8 months and a reference group of 686 consecutive patients (aged 60-98) referred during a previous period of 54 months. In the index group, a systematic psychiatric evaluation was performed in addition to the neurological evaluation and routine investigations. In the reference group, patients had the same basic evaluation, but psychiatric evaluation was optional and was performed in 21% of the patients. Measurements: Prevalence of primary psychiatric morbidity in the index and reference groups according to international clinical criteria and multidisciplinary consensus report and three key psychiatric symptoms: delusions, hallucinations, and affective symptoms in the index group. Results: Twenty-three percent of patients in the index group had a primary psychiatric disease. A primary psychiatric disease was diagnosed in 8% of patients in the reference group (P<.001). One or more psychiatric symptoms were identified in 72% of all patients in the index group. Conclusion: Psychiatric conditions and symptoms are frequent in elderly patients with cognitive symptoms, including those referred to a neurological memory clinic. The data provide evidence for a multispecialty and multidisciplinary approach to the diagnosis and management of patients with possible dementia.