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Clinical assessment of psychopathology among elderly residents (CAPER): Development and pilot testing of a screening instrument to detect the presence of psychiatric disorders among residents of long‐term instituions
Author(s) -
Reichenfeld H. F.,
Bazile E.,
Khan B. B.,
Raman S.
Publication year - 1992
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.930070604
Subject(s) - psychopathology , psychiatry , population , neuropsychology , mental health , epidemiology , medicine , psychiatric assessment , psychology , cognition , environmental health
Although psychiatric illnesses are common occurrences in institutions taking care of the elderly, admission is seldom preceded by a mental health evaluation and only rarely are there provisions for ongoing psychiatric care. Screening a population for specific psychiatric disorders is traditionally carried out by lay interviewers. In field studies organized under the Epidemiological Catchment Area Program of the National Institute of Mental Health they were specially trained to complete the Diagnostic Interview Schedule (DIS) (Munson et al. , 1985; Robins et al. , 1985). An initial examination carried out by a trained psychiatrist can, however, also be regarded as a screen for the detection of the presence or absence of a psychiatric disorder, and defining a ‘case’ (Leighton et al. , 1966). It represents the first step in the evaluation. The establishment of a specific diagnostic label, though at times possible as a result of one examination, is more usually determined at the second, third or fourth step after obtaining additional information from relatives or caregivers, and assessing the results of neuropsychological and biological tests. CAPER (Clinical Assessment of Psychopathology among Elderly Residents) was developed to provide in a semistructured format such a typical initial examination of elderly residents of long‐term institutions. It is designed to represent the first step in a comprehensive evaluation, can be completed in 15–20 minutes and generates clinically useful information. CAPER allows the examiner to draw conclusions commonly encountered in everyday practice and gives a choice between (1) no psychopathology, (2) definite psychopathology and (3) suspected psychopathology. A great deal of demographic data are also accumulated and entered into a specifically designed multi purpose computer program. The program can be used for epidemiological studies to determine the prevalence of specific disorders in different populations, but also has applications in correlating the findings of an initial clinical examination with the results of neuropsychological tests.