Medical morbidity in psychiatric (de-)institutionalized patients

Abstract

Introduction:

The physical comorbidity of chronic psychiatric patients is affected not only by their psychiatric condition and treatment but also by the different access they have to health care facilities.

Aim:

To record the medical morbidity of patients of the Psychiatric Hospital of Petra, Olympus, during its deinstitutionalization project.

Methods:

The physical diseases of 196 chronic psychiatric patients (71.4% men), who were treated in long-stay wards or in community-based psychiatric facilities, were recorded during the autumn of 2003.

Results:

Circulatory and neurological diseases were the most prevalent between psychiatric patients, both affecting 62 (31.6%) patients. Hypertenstion, coronary heart disease, stroke and dementia were quite frequent, approximately as much as in the general population. Epilepsy and hypotension were markedly frequent, possibly due to association with their psychiatric condition and its treatment. It is remarkable that anemia was the most frequent physical problem (25.5%), while 13.3% of the patients had a history of bone fractures. 14.8% of the patients had gastrointestinal problems (mostly ulcers), 15.3% had endocrinological (mainly diabetes) and 8.7% respiratory conditions. Finally, incontinence, prostate hyperplasia and other urological diagnoses were found in 10.7% of the patients.

Conclusions:

The (de)institutionalized psychiatric population seems to suffer by medical problems that are associated a) generally with their age and gender and b) specifically with their psychiatric condition and the side-effects of the corresponding medication. It is hoped and expected that the deinstitutionalization will help improve the treatment of the former without at least hindering the handling of the latter.