Characteristics of elderly patients attended at a psychiatry emergency room

Abstract

Introduction

There is no general agreement on the prevalence of mental disorders in the elderly, although it is estimated that 25%. of them present psychiatric symptoms. Geriatric psychiatry is one of the most rapidly advancing fields and requires a comprehensive approach.

Objectives

To analyse the characteristics of patients older than 65 who are attended at the psychiatry emergency room.

Methods

A descriptive study was conducted among all elderly pacients seen during May 2010 at the psychiatry emergency room at Vall d’Hebron University Hospital. Clinical variables (functional status, reason to show up, medical history, diagnosis), treatment and referral at discharge were analysed.

Results

36 patients (44.4% men, mean age 75.3 years) were identified. Charlson comorbidity index was 2.08. Suicide attempts were the most frequent reason for admission (27.8%), followed by psychomotor agitation (16.7%), anxiety disorders (13.9%), delirium (13.9%), depression (11.1%), and behaviour disorders (8.3%). Concerning psychiatric antecedents 58.3% had depressive disorder and 40% reported somatic symptoms during the month prior to their consultation.

The most common diagnosis at discharge were anxiety-depressive disorders (52.7%) and delirium (16.7%). The most widely prescribed psychotropics were antipsychotics (19.4% haloperidol, 13.9% quetiapine) followed by benzodiazepines (13.9%). Referral at discharge was: 41.7% home, 13.9% midterm psychiatric units, 27.8% acute psychiatric inpatient unit and 16.7% Internal Medicine.

Conclusions

Typically, elderly patients attended at the psychiatric emergency room are diagnosed of an anxiety-depressive disorder and often present with a suicidal attempt, but only 41.7% are admitted as psychiatric inpatients.