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Differences between elderly voluntary and involuntary admitted psychiatric patients in Greece

Published online by Cambridge University Press:  29 August 2012

Athanasios Douzenis ,
Ioannis Michopoulos ,
Rossetos Gournellis ,
Christos Christodoulou ,
Emmanouel N. Rizos ,
Dionysios Sakkas ,
Athanasios Karkanias ,
Ioannis Rontos ,
Georgios Bouras  and
Lefteris Lykouras
Athanasios Douzenis
Affiliation:
2nd Department of Psychiatry, University of Athens, Medical School, “Attikon” University General Hospital, Athens, Greece
Ioannis Michopoulos
Affiliation:
2nd Department of Psychiatry, University of Athens, Medical School, “Attikon” University General Hospital, Athens, Greece
Rossetos Gournellis
Affiliation:
2nd Department of Psychiatry, University of Athens, Medical School, “Attikon” University General Hospital, Athens, Greece
Christos Christodoulou
Affiliation:
2nd Department of Psychiatry, University of Athens, Medical School, “Attikon” University General Hospital, Athens, Greece
Emmanouel N. Rizos
Affiliation:
2nd Department of Psychiatry, University of Athens, Medical School, “Attikon” University General Hospital, Athens, Greece
Dionysios Sakkas
Affiliation:
Department of Psychiatric, General Hospital “G. Gennimatas,”Athens, Greece
Athanasios Karkanias
Affiliation:
Department of Psychiatric, General Hospital “Sotiria,”Athens, Greece
Ioannis Rontos
Affiliation:
Department of Psychiatric, General Hospital Nikaias, Piraeus, Greece
Georgios Bouras
Affiliation:
2nd Department of Psychiatry, University of Athens, Medical School, “Attikon” University General Hospital, Athens, Greece
Lefteris Lykouras*
Affiliation:
2nd Department of Psychiatry, University of Athens, Medical School, “Attikon” University General Hospital, Athens, Greece
*
Correspondence should be addressed to: Lefteris Lykouras, MD, PhD, FICPM, Professor in Psychiatry, 2nd Department of Psychiatry, University of Athens, Medical School, “Attikon” University General Hospital, 1 Rimini Street, 124 62 Athens, Greece. Phone: +30 2105832426; Fax: +30 2105326453. Email: [email protected].
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Abstract

Background: Involuntary psychiatric admission is a controversial issue with legislation varying from country to country. Research on elderly individuals being involuntary admitted has been limited. This study aims first at assessing whether elderly involuntary admitted patients (IAPs) differ with regard to demographic, psychopathological, and behavioral characteristics from voluntary admitted psychiatric patients (VAPs) and second to assess whether the former group should be treated in a different (special) way.

Methods: Forty IAPs were compared to 39 VAPs with regard to sociodemographic data, DSM-IV diagnosis, as well as behavioral issues recorded by the Patient–Staff Conflict Checklist – Shift Report (PSCC-SR). All patients were aged 60 years and over and were admitted in the psychiatric departments of four general hospitals in Athens. The study period lasted 12 months.

Results: VAPs were more likely to be suffering from mood disorders, while IAPs presented higher rates of delirium. From the 20 items of the PSCC-SR, differences were found only in two: IAPs presented more aggressive behavior during the first few days of admission whereas VAPs had committed recent suicide attempt just before admission.

Conclusion: From the clinical point of view, IAPs presented with delirium and more aggressive behavior, whereas, the VAPs presented with higher rates of mood disorder and suicidality. However, from the medicolegal point of view, our findings lend support to the argument of either setting a limited time frame for involuntary admission in elderly patients, and/or allowing for elderly individuals with acute organic conditions to be treated against their will.

Keywords

elderlyinvoluntary admissionmedicolegal aspects
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 1 , January 2013 , pp. 25 - 33
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Abderhalden, C., Needham, I., Dassen, T., Halfens, R., Fischer, J. E. and Haug, H. J. (2007). Frequency and severity of aggressive incidents in acute psychiatric wards in Switzerland. Clinical Practice and Epidemiology in Mental Health, 3, 30.CrossRefGoogle ScholarPubMed
Alexopoulos, G. S. (2005). Depression in the elderly. Lancet, 365, 1961–1970.CrossRefGoogle ScholarPubMed
Becker, T., Magliano, L. and Priebe, S. (2004). Evidence-based mental health services research. The contribution of some recent EU funded projects. In Kirch, W. (ed.), Public Health in Europe (pp. 173–187). Berlin: Springer.CrossRefGoogle Scholar
Bowers, L., Brennan, G., Flood, C., Lipang, M. and Oladapo, P. (2006). Preliminary outcomes of a trial to reduce conflict and containment on acute psychiatric wards: city nurses. Journal of Psychiatric and Mental Health Nursing, 13, 165–172.CrossRefGoogle ScholarPubMed
Brown, J., Khalil, A. and Salib, E. (1999). Audit of emergency detention. Elderly Care, 11, 14–17.Google ScholarPubMed
Conwell, Y. (2004). Suicide. In Roose, S. and Sackeim, H. (eds.), Late Life Depression (pp. 95–106). New York: Oxford University Press.CrossRefGoogle Scholar
Dibben, C., Saeed, H., Stagias, K., Khandaker, G. M. and Rubinsztein, J. S. (2008). Crisis resolution and home treatment teams for older people with mental illness. The Psychiatrist, 32, 268–270.Google Scholar
Douzenis, A.et al. (2010). Cognitive decline and dementia in elderly medical inpatients remain underestimated and underdiagnosed in a recently established university general hospital in Greece. Archives of Gerontology and Geriatrics, 50, 147–150.CrossRefGoogle Scholar
Draper, B. and Low, L. F. (2005). What is the effectiveness of acute hospital treatment of older people with mental disorders? International Psychogeriatrics, 17, 539–555.CrossRefGoogle ScholarPubMed
Dressing, H. and Salize, H. J. (2004). Compulsory admission of mentally ill patients in European Union Member States. Social Psychiatry and Psychiatric Epidemiology, 39, 797–803.CrossRefGoogle ScholarPubMed
Economou, C. (2010). Greece: health system review. Health Systems in Transition, 12, 1–xvi.Google ScholarPubMed
First, M. B., Spitzer, R. Z., Gibbon, M. and William, J. B. (1997). Structured Clinical Interview for DSM-IV Axis I Disorders Clinical Version (SCID IV). Washington, DC: American Psychiatric Press.Google Scholar
Gorman, M. (1999). Development and the rights of older people. In Randel, J., German, T. and Ewing, D. (eds.), The Ageing and Development Report: Poverty, Independence and the World's Older People (pp. 3–21). London: Earthscan Publications Ltd.Google Scholar
Gournellis, R., Lykouras, L., Fortos, A., Oulis, P., Roumbos, V. and Christodoulou, G. N. (2001). Psychotic (delusional) major depression in late life: a clinical study. International Journal of Geriatric Psychiatry, 16, 1085–1091.CrossRefGoogle ScholarPubMed
Gournellis, R., Oulis, P., Rizos, E., Chourdaki, E., Gouzaris, A. and Lykouras, L. (2011). Clinical correlates of age of onset in psychotic depression. Archives of Gerontology and Geriatrics, 52, 94–98.CrossRefGoogle ScholarPubMed
Gustafson, Y.et al. (1988). Acute confusional states in elderly patients treated for femoral neck fracture. Journal of the American Geriatrics Society, 36, 525–530.CrossRefGoogle ScholarPubMed
Inouye, S. K., Rushing, J. T., Foreman, M. D., Palmer, R. M. and Pompei, P. (1998). Does delirium contribute to poor hospital outcomes? A three-site epidemiologic study. Journal of General Internal Medicine, 13, 234–242.CrossRefGoogle ScholarPubMed
Jacoby, R. (2002). Old age psychiatry and the law. British Journal of Psychiatry, 180, 116–119.CrossRefGoogle ScholarPubMed
Johnson, S.et al. (2005a). Outcomes of crises before and after introduction of a crisis resolution team. British Journal of Psychiatry, 187, 68–75.CrossRefGoogle ScholarPubMed
Johnson, S.et al. (2005b). Randomised controlled trial of acute mental health care by a crisis resolution team: the north Islington crisis study. BJM, 331, 599.CrossRefGoogle Scholar
Joy, C. B., Adams, C. E. and Rice, K. (2006). Crisis intervention for people with severe mental illnesses. Cochrane Database of Systematic Reviews, 18, CD001087.Google Scholar
Ketelsen, R., Zechert, C., Driessen, M. and Schulz, M. (2007). Characteristics of aggression in a German psychiatric hospital and predictors of patients at risk. Journal of Psychiatric and Mental Health Nursing, 14, 92–99.CrossRefGoogle Scholar
Michopoulos, I.et al. (2010). Major depression in elderly medical inpatients in Greece, prevalence and identification. Aging Clinical and Experimental Research, 22, 148–151.CrossRefGoogle ScholarPubMed
Mossialos, E., Allin, S. and Davaki, K. (2005). Analysing the Greek health system: a tale of fragmentation and inertia. Health Economics, 14 (Suppl. 1), S151–S168.CrossRefGoogle ScholarPubMed
Quirk, A. and Lelliott, P. (2001). What do we know about life on acute psychiatric wards in the UK? A review of the research evidence. Social Science and Medicine, 53, 1565–1574.CrossRefGoogle Scholar
Sailas, E. and Fenton, M. (2000). Seclusion and restraint for people with serious mental illnesses. Cochrane Database of Systematic Reviews, 2, CD001163.Google Scholar
Salerno, S., Dimitri, L. and Talamanca, I. F. (2009). Occupational risk due to violence in a psychiatric ward. Journal of Occupational Health, 51, 349–354.CrossRefGoogle ScholarPubMed
Shah, A. and Dickenson, D. (1998). The Bournewood case and its implications for health and social services. Journal of the Royal Society of Medicine, 91, 349–351.CrossRefGoogle ScholarPubMed
Smith, B., Hassett, A., Harrigan, S. and Fortune, T. (2010). A profile of inpatient admissions to an aged psychiatry service in Victoria. Australasian Psychiatry, 18, 146–151.CrossRefGoogle Scholar
Soliman, A. E. and Reza, H. (2001). Risk factors and correlates of violence among acutely ill adult psychiatric inpatients. Psychiatric Services, 52, 75–80.CrossRefGoogle ScholarPubMed
United Nations (2009). Annual Report of the United Nations High Commissioner for Human Rights and Reports of the Office of the High Commissioner and the Secretary-General A/HRC/10/48. New York: UN Publications.Google Scholar