ABSTRACT

Dr Cohen has raised many challenging questions in his paper, any one of which is worthy of extensive discussion. This chapter begins by describing one diagnostic scheme that may have value in the diagnosis of older patients. Settlage distinguishes between: developmental disorders; situational disorders; neurotic disorders; neurotic character disorders; psychotic character disorders; psychotic disorders; and psychologic disorders associated with organic brain damage. Psychoanalysis did not always, and perhaps still does not; recognize that older adults can be treated. About fifteen years after Freud expressed these views on old people, Karl Abraham wrote a paper on "The applicability of psychoanalytic treatment to patients at an advanced age". Abraham conveys not only a sense of therapeutic optimism and personal gratification in working with older patients, but stimulates as well a number of basic questions about the factors which influence the course of and the prognosis for mental disorders. Being an "only child" could be seen as an additional factor of "loneliness".