The referral, investigation and diagnosis of presenile dementia: Two services compared

The case notes of 28 patients with presenile dementia presenting to a neurology service were compared with 26 who had presented to a specialist old age psychiatric department (OAPD). Referrals to the former were mainly from hospital doctors for diagnostic purposes. General practitioners referred more often to the OAPD and the patients were older. The reasons were more heterogeneous, but oriented to aspects of practical management of behavioural disturbance. Patients referred to the OAPD were inadequately investigated. It is concluded that specialist old age psychiatric services in Britain have a role in the management of patients with presenile dementia but that diagnosis should be undertaken by neurologists.