Article

[Reasons for referral to a gerontopsychiatric department].

Klinik für Psychiatrie und Psychotherapie, Vivantes Klinikum Hellersdorf, Myslowitzer Strasse 45, 12621 Berlin.
Der Nervenarzt (Impact Factor: 0.79). 04/2008; 79(3):340-7.
Source: PubMed

ABSTRACT

The need of specific gerontopsychiatric wards has not been estimated thus far, although psychiatric disorders are very common among the elderly.
The purpose of this study was to describe reasons for referral of old patients to a psychiatric department providing full services for 252,000 inhabitants.
All 975 admissions within 2 years were evaluated in this prospective study.
During the study period 645 patients aged over 64 years were admitted 830 times to the gerontopsychiatric wards. About half of them were referred by physicians in private practice, about 30% came via the emergency room, and 18% were transferred from other departments or hospitals. The most frequent reasons for referral were disorientation, confusion, or delirious states (31.9%), hallucinations or delusion (21.6%), aggression or excitation (17.7%), depression (17.6%), refusal of feeding or drinking (14.4%), agitation or restlessness (13.9%), suicidality or suicide attempt (13.3%), and disruptive behaviour (13.0%). In 81.8% of the cases, behaviour endangering themselves or others was an important cause of referral. The amount of specific gerontopsychiatric beds needed in hospital was estimated as ten beds per 10,000 inhabitants aged 65 or more.
The greatest proportion of the patients referred to gerontopsychiatric wards showed behaviour endangering themselves or others-typical indications for psychiatric inpatient treatment.

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    • "Currently, there are no guidelines or recommendations concerning the indication for inpatient psychiatric admission [9] [10] [11]. Factors unique to each patient may lead to different treatment strategies. "
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