YPSP01-03 - “No Country For Old Men”: Consultation-Liaison Psychiatry Activities In A Geriatric Population

Abstract

Objectives

Eighteen percent of Italian population and 37% of admissions to general hospital are represented by over-65 subjects. Psychiatric comorbility of hospitalized elderly patients is an epidemiologically and clinically significant phenomenon for Consultation-Liaison (CL) psychiatrists. The aim of the work is to describe the experience of a CL Psychiatry Service with patients aged 65 and more.

Methods

A search through the clinical database of the Modena CL Psychiatry Service was conducted, to collect data on psychiatric consultations for over-65 patients. Demographics, data on the reason for referral and on outcome of consultations were collected and analyzed critically, with special focus on clinically relevant situations.

Results

Over-65 patients account for 43% of all consultations (males 44%, mean age 75±13). Sixty-seven percent of referrals come from Internal Medicine wards and the most common reasons for referral are depression (42%), agitation (10%) and confusion (8%), with the distribution of frequency of reasons for referral differing significantly from that of under-65 patients (p=.003). A medical-psychiatric comorbidity was assessed in 77% of cases, with adjustment reactions and mixed anxiety-depression as most common psychiatric diagnoses (67%). Prescription of psychothropic drugs was the outcome of the psychiatric assessment in 78% of cases.

Conclusions

CL Psychiatry activities for elderly patients in the general hospital are frequent and clinically challenging. Unmet needs for elderly inpatients might be the underestimated question concerning coping strategies and adjustment reactions toward the presence of a medical illness.