Development of a tool to detect older adults with severe personality disorders for highly specialized care.

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.