[Personality disorders in older adults: a Delphi-study conducted among Dutch and Belgian experts concerning specific diagnostic and therapeutic aspects]. / Persoonlijkheidsstoornissen bij ouderen: delphi-onderzoek onder Nederlandse en Vlaamse experts over specifieke diagnostische en therapeutische aspecten.

BACKGROUND: In psychiatry for older adults (> 60 years) personality disorders play an important part in diagnosis and treatment and in the advice given to health professionals and carers on how to deal with this age group. So far, however, research in this area has been inadequate. AIM: To investigate age-related diagnostic and therapeutic aspects of personality disorders occurring in adults over the age of 60. METHOD: A Delphi-study was conducted among 35 Dutch and Belgian experts in the field of personality disorders in older adults. This multidisciplinary panel consisted of psychiatrists, psychologists, psychotherapists, geriatricians and psychiatric nurses. In four rounds 21 gerontological statements to be assessed on a 5-point Likert scale were presented to the panel of experts. Agreement was said to be reached when at least two thirds of the experts agreed or fully agreed with a statement.RESULTS Satisfactory agreement was reached in the case of 20 of the 21 diagnostic and/or therapeutic statements about older adults with personality disorders. CONCLUSION There seem to be various age-specific aspects in the diagnosis and treatment of personality disorders in older adults. Therefore, it is advisable to pay more attention to this highly complex group of older adults when guidelines and protocols are being drawn up and scientific research is being planned or conducted.

[Treatment of personality disorders in older adults. Three case studies]. / Behandeling van persoonlijkheidsstoornissen bij ouderen: drie gevalsbeschrijvingen.

Treatment of personality disorders in older adults is a highly underexposed subject. In this article it is illustrated by means of three case studies that a) treatment of personality disorders in the elderly is meaningful; b) it is useful in clinical practice to identify three levels of treatment, that is personality changing, adaptation enhancing and supportive-structuring treatment; c) at each level of treatment gerontologic aspects must be taken into account, such as increasing experiences of loss, how elderly people perceive somatic diseases and their disabling consequences, their changing life perspective, cohort-related and sociocultural beliefs, and the importance of intergenerational linkages. Further research is necessary whether the findings from these case studies can be generalised.

[Multidisciplinary guideline Personality disorders considered in more detail for older adults]. / Multidisciplinaire richtlijn Persoonlijkheidsstoornissen; nader gespecificeerd voor ouderen.

This article deals with the question of whether the recently published Multidisciplinary guideline on Personality disorders is unreservedly applicable to older persons. It is concluded that the guideline is on the whole of clinical relevance with regard to older persons, but for such persons certain aspects of the guideline concerning for instance the course of the disorder, diagnosis and treatment, need to be modified. Since the Netherlands has a steadily ageing population, greater concern for older persons with personality disorders is not only of clinical relevance, but is also essential for scientific research in the future.