Advice from a Liaison Psychiatrist specialising in Older Adults
This information is sourced from Dr Jayati Das-Munshi, Consultant Liason Psychiatrist for Older Adults
Q. When does anxiety about leaving the home become problematic/meet criteria for social phobia?
A. I’d suggest that the GP take a broader history before making this diagnosis:
- In particular screen for comorbid depression, alcohol use, cognitive impairment/ dementia.
- Use screening tools to assist (eg. GDS (depression), AUDIT (alcohol), MMSE (cognition)
- If possible speak to a carer or someone else who knows the patient well to get a longer term view (what was their function 6-12 months ago, are there other issues apparent indicating decline) and see the patient at home
- Assess the situation prior to lock down
In short it is very unusual for a condition like this to suddenly appear in later life (although these are unprecedented times, and this is based on pre-lockdown evidence) but if concerns around comorbidities or risk (self neglect, suicidality etc), consider onward referral to CMHT