Problems of Middle Adult Life
Middle adult life may be applied to ages 30 to 65 years, which are characterized developmentally by consolidation and generativity in career and family life. Although potentially the most productive years of life, they are also fraught with obstacles and frustrations in the achievement of personal goals. Common stressors include marriage and divorce, parenting, career setbacks, recognition of unattainable goals and death of parents. Any of these may serve as the focus of a midlife crisis.
Psychosocial stressors may precipitate episodes of already exist-ing disorders of virtually any type or initiate disorders de novo. Relatively few disorders have a typical onset between 30 and 65 years (Table 8.11). They include particular anxiety, psychotic, sleep and substance-related disorders, and disorders associated with general medical conditions
Because medical conditions have increased incidence during adult life, psychopathological conditions resulting from the direct physiological effects of general medical conditions are on the rise. General medical conditions (and their treatments) can cause delirium, dementia, amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, catatonic disorder, sexual dysfunction, sleep disorder and personality disorder.
Medical conditions can also act as psychosocial stressors (Popkin et al., 1987), in which case the prognosis also depends on the management of the stress and the treatment of the mental disorder.
The estimated prevalence and sex distribution of the few mental disorders with a peak in age at onset in middle adult life are included in Table 8.10