Affective Disorder Arising in the Senium II. Physical Disability As an Aetiological Factor

In previous papers (Roth and Morrissey, 1952; Roth, 1955) evidence for the importance of affective psychosis in old age was presented. It was shown further that in some half of those admitted after the age of 60 no attacks had occurred before this age, and that no new aetiological factor such as cerebral degeneration was associated with these cases of late onset (Kay, Roth and Hopkins, 1955). The problem is to elucidate why it is that defences against illness effective throughout most of these patients' lives prove inadequate in old age. Now in the study just referred to, a tendency for physical illness to be commoner in patients having their first attack after 60 was noted. A more detailed analysis of the incidence of physical illness in the two groups has therefore been carried out in order to investigate its possible aetiological role in old age affective disorder.