The psychosocial age: a tool to reduce the institutional stigma of elderly people with mental disorders.

In line with previous studies on elderly with mental disorders discrimination, a concept called "Psychosocial age" has been methodologically formalized and mathematically modelized. Its aim is to support health providers and hinder stigmatization process which is influenced by social representations of our population. This article presents the construction of this indicator and its clinical implications. A literature review was therefore firstly conducted to isolate the involved cognitive functions in psychosocial adaptation. Then a second literature review isolated French-language valid tests and their retained scores for mathematical modelization on each aforementioned selected cognitive function. Nine databases were reviewed (PsychInfo and PsycArticles, ScienceDirect, Web of Science, PubMed (Medline), Taylor & Francis, the Wiley Online Library, Cairn and Google Scholar). The selected articles are both in French or English and the publication period is between 2000 and 2017. The mathematical modelization is then psychometrically presented and illustrated by too clinical illustrations. Finally, strength and limits of the psychosocial age are exposed especially highlighting its interest in the institutional decision process.

How to facilitate the orientation of elderly subjects with psychical disabilities to a health alternative to hospitalization?

This paper is aimed to improve the socio-psycho-therapeutic support for older patients with heavy psychiatric disability. First, we review the literature to question the specific grounds reported by professionals regarding the orientation of these vulnerable subjects. Secondly, we emphasize that integration of these subjects within alternatives to hospitalization requires a type of support similar to that usually proposed, an accompaniment of psychosocial rehabilitation. Then, we propose to build an indicator called the psychosocial age, which reduces the weight of the chronological age for the orientation of these subjects. Ultimately, we question the health policies in psychiatry.