In a psychiatric census of a 196-bed acute inpatient Medicine for the Elderly unit, 76.1% of patients resident during 1 week were screened and interviewed in a two-stage diagnostic procedure. Of 153 patients studied, 11.1% were delirious, 26.8% were demented, and 9.2% were depressed. Overall, 56.9% of the cases were identified by ward nurses, and 55.5% by the ward doctors; taken together, ward staff identified 75.0% of the cases (kappa = 0.46), indicating that detection of psychiatric disorder in this population might be improved if doctors and nurses pooled their observations on this aspect of patient assessment.