Linda A E Laheij-Rooijakkers1, Paul T van der Heijden2, Arjan C Videler3,4,5, Daniel L Segal6, Sebastiaan P J van Alphen1,7,8. 1. Department of Old Age Psychiatry, Mondriaan Hospital, Center of Excellence for Personality Disorders in Older Adults, Heerlen-Maastricht, The Netherlands. 2. Reinier van Arkel Mental Health Institute, The Netherlands. 3. PersonaCura, Clinical Centre of Excellence for Personality Disorders and Autism Spectrum Disorders in Older Adults, GGz Breburg, Tilburg, The Netherlands. 4. Clinical Centre of Excellence for Body, Mind and Health, Tilburg, The Netherlands. 5. Tranzo Department, Tilburg University, Tilburg, The Netherlands. 6. Department of Psychology, University of Colorado, Colorado Springs, CO, USA. 7. Faculty of Psychology & Educational Sciences, Department of Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium. 8. Department of Medical and Clinical Psychology, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
Abstract
OBJECTIVES: Current guidelines recommend highly specialized care for patients with severe personality disorders (PDs). However, there is little knowledge about how to detect older patients with severe PDs. The aim of the current study was to develop an age-specific tool to detect older adults with severe PDs for highly specialized mental health care. DESIGN: In a Delphi study, a tool to detect adults with severe PDs for highly specialized mental health care was adjusted for older adults based on expert opinion. Subsequently, the psychometric properties of the age-specific tool were evaluated. SETTING: The psychometric part of the study was performed in two Dutch highly specialized centers for PDs in older adults. PARTICIPANTS: Patients (N = 90) from two highly specialized centers on PDs in older adults were enrolled. MEASUREMENTS: The age-specific tool was evaluated using clinical judgment as the gold standard. RESULTS: The Delphi study resulted in an age-specific tool, consisting of seven items to detect older adults with severe PDs for highly specialized mental health care. Psychometric properties of this tool were evaluated. Receiver operating curve analysis showed that the questionnaire was characterized by sufficient diagnostic accuracy. Internal consistency of the tool was sufficient and inter-rater reliability was moderate. CONCLUSIONS: An age-specific tool to detect older adults with severe PDs was developed based on expert opinion. Psychometric properties were evaluated showing sufficient diagnostic accuracy. The tool may preliminarily be used in mental health care to detect older adults with severe PDs to refer them to highly specialized care in an early phase.
OBJECTIVES: Current guidelines recommend highly specialized care for patients with severe personality disorders (PDs). However, there is little knowledge about how to detect older patients with severe PDs. The aim of the current study was to develop an age-specific tool to detect older adults with severe PDs for highly specialized mental health care. DESIGN: In a Delphi study, a tool to detect adults with severe PDs for highly specialized mental health care was adjusted for older adults based on expert opinion. Subsequently, the psychometric properties of the age-specific tool were evaluated. SETTING: The psychometric part of the study was performed in two Dutch highly specialized centers for PDs in older adults. PARTICIPANTS: Patients (N = 90) from two highly specialized centers on PDs in older adults were enrolled. MEASUREMENTS: The age-specific tool was evaluated using clinical judgment as the gold standard. RESULTS: The Delphi study resulted in an age-specific tool, consisting of seven items to detect older adults with severe PDs for highly specialized mental health care. Psychometric properties of this tool were evaluated. Receiver operating curve analysis showed that the questionnaire was characterized by sufficient diagnostic accuracy. Internal consistency of the tool was sufficient and inter-rater reliability was moderate. CONCLUSIONS: An age-specific tool to detect older adults with severe PDs was developed based on expert opinion. Psychometric properties were evaluated showing sufficient diagnostic accuracy. The tool may preliminarily be used in mental health care to detect older adults with severe PDs to refer them to highly specialized care in an early phase.